Endothelial dysfunction, oxidative stress and low-grade endotoxemia in COVID-19 patients hospitalised in medical wards

Ciacci, Paolo; Paraninfi, Aurora; Orlando, Federica; Rella, S; Maggio, Enrico; Oliva, Alessandra; Cangemi, Roberto; Carnevale, Roberto; Bartimoccia, Simona; Cammisotto, Vittoria; D’Amico, Alessandra; Magna, Arianna; Nocella, Cristina; Mastroianni, Claudio Maria; Pignatelli, Pasquale; Violi, Francesco; Loffredo, Lorenzo

doi:10.1016/j.mvr.2023.104557

Cited by 6 publications

(7 citation statements)

References 47 publications

(60 reference statements)

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“… 32 Furthermore, recent reports showed that low-grade endotoxaemia is detectable in patients with COVID-19 and is associated with thrombotic events, probably due to activation of NOX-2, increased oxidative stress, low bioavailability of nitric oxide and endothelial dysfunction. 33 , 34 A change in the microbiota and persistent microbial translocation has been observed during severe SARS-CoV-2 infections, a condition that could play a pathogenetic role in BSI development during COVID-19, a hypothesis supported by the high rate of primary bacteraemia that we observed. 33 , 35 , 36 A recent study evaluated the possible role of a persistent high level of microbial translocation as the pathogenetic trigger for the development of primary BSI following Clostridioides difficile infection (CDI); the authors found that patients who developed primary BSI maintained high levels of LPS-binding protein (LBP) and low levels of EndoCAb IgM, both markers of microbial translocation, while patients who did not develop BSI showed a reduction of microbial translocation levels, similar to that of healthy donors.…”

Section: Discussionsupporting

confidence: 66%

Risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections and related mortality in critically ill patients with CRAB colonization

Dezza

Covino

Petrucci

et al. 2023

JAC-Antimicrobial Resistance

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Background Among MDR bacteria, carbapenem-resistant Acinetobacter baumannii (CRAB) is a major concern due to the limited therapeutic options. During the COVID-19 pandemic, a worrying increase in the spread of CRAB infections was reported. Objectives The study assessed the risk factors for CRAB bloodstream infection (BSI) in patients admitted to the ICU with CRAB colonization, and the related mortality risk factors. Methods We conducted a single-centre, observational, prospective study; all consecutive patients with CRAB colonization admitted to the ICU of a tertiary hospital in Rome from January 2021 to September 2022 were included in the study. Univariate and multivariate analyses were performed to investigate BSI and mortality risk factors. Results Overall, 129 patients were included in the study; 57 (44%) out of these developed BSI. In our study population, at the multivariable analysis the Charlson comorbidity index (CCI) (P = 0.026), COVID-19 (P < 0.001), multisite colonization (P = 0.016) and the need for mechanical ventilation (P = 0.024) were risk factors independently associated with BSI development. Furthermore, age (P = 0.026), CCI (P < 0.001), septic shock (P = 0.001) and Pitt score (P < 0.001) were independently associated with mortality in the BSI patients. Instead, early appropriate therapy (P = 0.002) and clinical improvement within 72 h (P = 0.011) were shown to be protective factors. Conclusions In critically ill patients colonized by CRAB, higher CCI, multisite colonization and the need for mechanical ventilation were identified as risk factors for BSI onset. These predictors could be useful to identify patients at highest risk of BSI.

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Section: Discussionsupporting

confidence: 66%

Risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections and related mortality in critically ill patients with CRAB colonization

Dezza

Covino

Petrucci

et al. 2023

JAC-Antimicrobial Resistance

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“…Some clinical studies have shown that the gut microbiota in COVID-19 patients is significantly different from that of healthy controls [41]. The level of gut dysbiosis has been reported to be directly proportional to the severity of COVID-19 and the concentrations of pro-inflammatory and pro-oxidative markers in the plasma [38][39][40] (Figure 1).…”

Section: Effects Of Gut Microbiota On the Development And Prognosis O...mentioning

confidence: 99%

“…Several authors have suggested the existence of direct communication between gut microbiota and lungs, known as the gut-lung axis, which allows the bidirectional transport of microbial toxins and metabolites synthesized by gut and lung microbiota through the lymphatic and circulatory system [35][36][37]. Therefore, gut microbiota disorders would be responsible for worsening respiratory outcomes such as in a SARS-CoV-2 infection [35][36][37][38][39][40]. Thus, gut microbiota composition may explain, at least in part, the susceptibility, intensity, and prognosis of the infection by SARS-CoV-2 in human patients, which would make gut microbiota intervention an important strategy to resolve or mitigate this pathology.…”

Section: General Concept Of Gut Microbiota In a Healthy State And In ...mentioning

confidence: 99%

“…Furthermore, oxidative stress has been considered as another important factor affecting COVID-19 [61]. In COVID-19 patients, 8-isoprostaglandin F2 alpha levels, considered as a marker of oxidative tissue damage, were elevated [62], and in a recent study [38], COVID-19 patients showed significantly higher values of hydrogen peroxide (H 2 O 2 ) and NADPH oxidase 2 (NOX2) activity in serum, as well as TNF-α and IL-6. These results were accompanied by an increase in the serum levels of zonulin, an indirect marker of the permeability of the intestinal mucosa [63].…”

Section: Effects Of Covid-19 On Microbiota Alterationsmentioning

confidence: 99%

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Gut Microbiota Dysbiosis in COVID-19: Modulation and Approaches for Prevention and Therapy

Martín Giménez,

Modrego,

Gómez-Garre

et al. 2023

IJMS

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Inflammation and oxidative stress are critical underlying mechanisms associated with COVID-19 that contribute to the complications and clinical deterioration of patients. Additionally, COVID-19 has the potential to alter the composition of patients’ gut microbiota, characterized by a decreased abundance of bacteria with probiotic effects. Interestingly, certain strains of these bacteria produce metabolites that can target the S protein of other coronaviruses, thereby preventing their transmission and harmful effects. At the same time, the presence of gut dysbiosis can exacerbate inflammation and oxidative stress, creating a vicious cycle that perpetuates the disease. Furthermore, it is widely recognized that the gut microbiota can metabolize various foods and drugs, producing by-products that may have either beneficial or detrimental effects. In this regard, a decrease in short-chain fatty acid (SCFA), such as acetate, propionate, and butyrate, can influence the overall inflammatory and oxidative state, affecting the prevention, treatment, or worsening of COVID-19. This review aims to explore the current evidence regarding gut dysbiosis in patients with COVID-19, its association with inflammation and oxidative stress, the molecular mechanisms involved, and the potential of gut microbiota modulation in preventing and treating SARS-CoV-2 infection. Given that gut microbiota has demonstrated high adaptability, exploring ways and strategies to maintain good intestinal health, as well as an appropriate diversity and composition of the gut microbiome, becomes crucial in the battle against COVID-19.

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“…More recently, NOX2 and NOX5 have been shown to be increased in the cardiac microvascular endothelium of deceased COVID-19 patients, which may contribute to their previously reported cardio-microvascular dysfunction [ 121 ]. Recently, it has been shown that patients with COVID-19 have significant higher markers of oxidative stress (such as soluble Nox2-derived peptide and hydrogen peroxide) and inflammation (TNF-α and IL-6), while, conversely, flow-mediated dilation, hydrogen peroxide breakdown activity and nitric oxide (NO) bioavailability were shown to be significantly lower [ 122 ].…”

Section: Covid-19 Obesity Inflammation and Oxidative Stress In Cardio...mentioning

confidence: 99%

Cross-Talk of NADPH Oxidases and Inflammation in Obesity

Morawietz¹,

Brendel²,

Diaba-Nuhoho

et al. 2023

Antioxidants

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Obesity is a major risk factor for cardiovascular and metabolic diseases. Multiple experimental and clinical studies have shown increased oxidative stress and inflammation linked to obesity. NADPH oxidases are major sources of reactive oxygen species in the cardiovascular system and in metabolically active cells and organs. An impaired balance due to the increased formation of reactive oxygen species and a reduced antioxidative capacity contributes to the pathophysiology of cardiovascular and metabolic diseases and is linked to inflammation as a major pathomechanism in cardiometabolic diseases. Non-alcoholic fatty liver disease is particularly characterized by increased oxidative stress and inflammation. In recent years, COVID-19 infections have also increased oxidative stress and inflammation in infected cells and tissues. Increasing evidence supports the idea of an increased risk for severe clinical complications of cardiometabolic diseases after COVID-19. In this review, we discuss the role of oxidative stress and inflammation in experimental models and clinical studies of obesity, cardiovascular diseases, COVID-19 infections and potential therapeutic strategies.

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Endothelial dysfunction, oxidative stress and low-grade endotoxemia in COVID-19 patients hospitalised in medical wards

Cited by 6 publications

References 47 publications

Risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections and related mortality in critically ill patients with CRAB colonization

Risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections and related mortality in critically ill patients with CRAB colonization

Gut Microbiota Dysbiosis in COVID-19: Modulation and Approaches for Prevention and Therapy

Cross-Talk of NADPH Oxidases and Inflammation in Obesity

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