Although the original data on systemic oxidative stress in COVID-19 patients have recently started to emerge, we are still far from a complete profile of changes in patients’ redox homeostasis. We aimed to assess the extent of oxidative damage of proteins, lipids and DNA during the course of acute disease, as well as their association with CT pulmonary patterns. In order to obtain more insight into the origin of the systemic oxidative stress, the observed parameters were correlated with inflammatory biomarkers and biomarkers of multiorgan impairment. In this prospective study, we included 58 patients admitted between July and October 2020 with COVID-19 pneumonia. Significant changes in malondialdehyde, 8-hydroxy-2’-deoxyguanosine and advanced oxidation protein products levels exist during the course of COVID-19. Special emphasis should be placed on the fact that the pattern of changes differs between non-hospitalized and hospitalized individuals. Our results point to the time-dependent relation of oxidative stress parameters with inflammatory and multiorgan impairment biomarkers, as well as pulmonary patterns in COVID-19 pneumonia patients. Correlation between redox biomarkers and immunological or multiorgan impairment biomarkers, as well as pulmonary CT pattern, confirms the suggested involvement of neutrophils networks, IL-6 production, along with different organ/tissue involvement in systemic oxidative stress in COVID-19.
Sustained and dysregulated inflammation, concurrent tumor-induced immune suppression, and oxidative stress are profoundly involved in cancer initiation, presentation, and perpetuation. Within this prospective study, we simultaneously analyzed the preoperative indices of systemic inflammatory response and the representative byproducts of oxidative DNA, protein, and lipid damage with the aim of evaluating their clinical relevance among patients diagnosed with testicular germ-cell tumors (GCT). In the analytical cohort (n = 88, median age 34 years), neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and C-reactive protein (CRP) were significantly altered in patients with a higher tumor stage (p < 0.05). Highly suggestive correlations were found between NLR, dNLR, and SII and modified nucleoside 8-OHdG. CRP and albumin-to-globulin ratio (AGR) significantly correlated with thiols group level and maximal tumor dimension (p < 0.05). Based on receiver operating characteristic (ROC) curve analyses, all the evaluated pre-orchiectomy inflammation markers demonstrated strong performance in predicting metastatic disease; optimal cut-off points were determined for each indicator. Although further large-scale studies are warranted, inflammatory and redox indices may both complement the established tumor markers and standard clinicopathological prognostic variables and contribute to enhanced personalized risk-assessment among testicular GCT patients.
Background. Metabolic alterations, particularly disorders of lipoprotein metabolism in COVID-19, may affect the course and outcome of the disease. This study aims at evaluating the lipoprotein profile and redox status in SARS-CoV-2 infected patients with different pneumonia severity and their association with lethal outcomes. Methods. The prospective cohort study was performed on 98 COVID-19 patients with mild, moderate, and severe pneumonia. Lipid and inflammatory parameters, lipoprotein subclasses, and redox status biomarkers were determined at the study entry and after one week. Results. Compared to patients with mild and moderate pneumonia, severely ill patients had higher oxidised low-density lipoprotein (oxLDL) and malondialdehyde levels and lower high-density lipoprotein cholesterol (HDL-C) concentrations and paraoxonase 1 activity. Reduction in the proportion of large HDL 2a subclasses with a concomitant increase in the proportion of smallest HDL 3c and small dense LDL (sdLDL) particles was observed in patients with severe disease during the time. However, these changes were reversed in the mild and moderate groups. The results showed a positive association between changes in oxLDL and total antioxidative status. However, prooxidants and antioxidants in plasma were lower in patients with lethal outcomes. Conclusions. Increased levels of oxLDL and sdLDL particles may contribute to the severity of COVID-19. The role of oxidative stress should be clarified in further studies, mainly its association with lethal outcomes.
Background/Aim. The COronaVIrus Disease 2019 (COVID-19) primarily affects the respiratory system, so radiological diagnosis has been shown to be necessary. Chest computed tomography (CT) is to be shown the best modality in suspected COVID-19 cases for initial evaluation because CT findings may be present before the onset of symptoms. The purpose of this study is to show different CT imaging features or patterns in COVID-19 patients with a different time course and disease severity. Methods. This is a prospective cohort study that analysed 330 patients (the average age was 52.37?15.36) with confirmed COVID-19 via laboratory testing. During hospitalization, all patients included in the study underwent chest CT in order to assess the extent of changes in their lungs. Because chest CT images could show different imaging features or patterns in COVID-19 patients with a different time course and disease severity, we classified them into four categories: lung, bronchial, pleural and mediastinal changes. Based on the time interval between the onset of symptoms and the CT scan, all patients were divided into three groups: group 1 (CT scans done ?1 week after symptom onset); group 2 (CT scans done >1 to 2 weeks after symptom onset); group 3 (CT scans done >2 weeks after symptom onset). In order to more accurately monitor the distribution of changes in the lungs, bilateral lungs were divided into 12 ?lung? zones. Each zone was assigned a CT score. ?Total severity score? was calculated by summing the scores for each zone. Results. In 93.6% patients with COVID-19 the CT findings were positive. About 92.1% patients had multiple lesions. The lesions were bilateral in 87.6% of patients, had both peripheral and centrally localised lesions in 63.3% of patients, and occurred more frequently in posterior areas (93%), as well as in lower lung zones (91.2%). The average ?Total severity score? was 11.00 (7.00-16.00). The most common CT findings in all patients are the ground- glass opacities (97.7%), reticular pattern (91.3%), consolidation (71.5%) and fibrotic streaks (63.8%). When the time interval is monitored between onset of symptoms and the CT scan, it is noticed that in group 1 changes on CT were found in 80.0% of patients, in group 2 in 95.0%, and in group 3 in 99.4%. Conclusion. CT has proven to be a very important diagnostic method in COVID-19 patients, and together with clinical and laboratory findings, gives a complete picture of the patient's condition and significantly contributes to decision- making for further treatment.
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