Long-COVID sequelae are associated with oxidative stress in hemodialysis patients

Abstract

pathophysiology of long-COVID sequelae in the general population of SARS-CoV-2-infected patients has been shown to be strongly influenced by oxidative stress. However, the potential role of oxidative stress in the development of long-COVID sequelae in hemodialysis patients (HD) has never been investigated.
 The present study aimed to evaluate the oxidative status of HD patients 3.5 months after SARS-CoV-2 infection in relation to the presence of long-COVID sequelae and the severity of the acute phase COVID-19.
 Methods. This cross-sectional cohort study included 63 HD patients with a median age of 55 (43-62.5) years and a dialysis vintage of 42 (25-73) months who had been infected with COVID-19 at least 3 months before recruitment. Patients were divided into two groups according to the occurrence of long-COVID sequelae: Group 1 included 31 (49.2%) HD patients with sequelae, while Group 2 included 32 (50.8%) fully recovered individuals. At 3.5 (3.2-4.6) months after the acute phase of COVID-19, malondialdehyde (MDA) and erythrocyte levels (MDAe), sulfhydryl groups (SH -groups), serum catalase activity, transferrin, and ceruloplasmin were measured. A comparison of the obtained data was performed using the Student’s test or the Mann-Whitney test according to the data distribution. A correlation was evaluated with the Spearman test.
 Results. HD patients with persistent long-COVID sequelae had significantly higher concentrations of MDAs (p = 0.002), MDAe (p = 0.0006), and CTs (p = 0.02), and lower serum levels of SH-groups (p = 0.03) and ceruloplasmin (p = 0.03) compared with Group 2. The concentration of most studied indicators of pro- and antioxidant status did not depend on the severity of the acute phase COVID-19, and only catalase activity was statistically significantly related to the need for hospitalization (r = 0.59; p = 0.001), oxygen support (r = 0.44; p = 0.02), and the percentage of lung injury according to computed tomography (p = 0.03). Although the serum concentration of transferrin did not differ between the studied groups, the individual analysis showed that its value was statistically higher in HD patients with severe COVID-19 even 3.5 months after infection (p < 0.0001).
 Conclusions. Long-term COVID-19 sequelae in HD patients are associated with oxidative stress. High levels of catalase activity and serum transferrin 3.5 months after COVID-19 may be a consequence of the severe course of the acute phase of the disease. The obtained data suggest that the use of antioxidants may be one of the possible strategies to treat the long-term consequences of COVID in HD patients.

Pre-infection Nutritional Status, Oxidative Stress, and One-Year Long COVID Persistence in Patients Undergoing Hemodialysis: A Prospective Cohort Study

“…Elevated levels of oxidative damage markers, such as MDAs, and reduced levels of ceruloplasmin were observed in our cohort of HD patients with moderate pre-infection nutritional deficiencies, suggesting that oxidative stress may play a significant role in the chronicity of COVID-19 sequelae. Our previous report also demonstrated significantly increased oxidative stress and decreased antioxidant markers in patients undergoing HD with long COVID compared to fully recovered patients [29]. Additionally, in line with our findings, Stufano et al proposed MDAs as an independent predictor of long COVID in Italian workers [30], while Restea et al demonstrated decreased ceruloplasmin levels in patients with type 2 diabetes and severe COVID-19 [31].…”

Pre-Infection Nutritional Status, Oxidative Stress, and One-Year-Long COVID Persistence in Patients Undergoing Hemodialysis: A Prospective Cohort Study

“…Elevated levels of oxidative damage markers, such as MDAs, and reduced levels of ceruloplasmin were observed in our cohort of HD patients with moderate pre-infection nutritional deficiencies, suggesting that oxidative stress may play a significant role in the chronicity of COVID-19 sequelae. Our previous report also demonstrated significantly increased oxidative stress and decreased antioxidant markers in patients undergoing HD with long COVID compared to fully recovered patients [ 34 ]. Additionally, in line with our findings, Stufano et al proposed MDAs as an independent predictor of long COVID in Italian workers [ 35 ], and Restea et al demonstrated decreased ceruloplasmin levels in patients with type 2 diabetes and severe COVID-19 [ 36 ].…”

Low High-Density Lipoprotein Level Associated With Enhanced Inflammatory Response and One-Year Persistence of Long Covid in Patients Undergoing Hemodialysis: A Cross-Sectional Cohort Study

“…The aftermath of acute SARS-CoV-2 infection has given rise to a complex and multifaceted condition known as long COVID, characterized by persistent symptoms that endure beyond the acute phase of the disease [1,2]. For individuals undergoing hemodialysis (HD), the challenges posed by long COVID are particularly pronounced, as this patient population already contends with the intricate interplay of renal complications and heightened susceptibility to infections [2][3][4]. Long COVID was found to be highly prevalent in COVID-19 survivors, representing more than 80% of all cases in the HD population [5,6].…”