Oxidant and antioxidant balance in patients with COVID‐19

Abstract

Background: A crucial balance exists between oxidant and antioxidant mechanisms in the functional immune system. We aimed to evaluate the contributions of balance between these systems to coronavirus disease 2019 (COVID-19), a devastating pandemic caused by viral infection.Method: We analyzed serum oxidant and antioxidant stress parameters according to the clinical and demographic characteristics of children and adults with COVID-19 and compared them against the values of healthy controls. Serum native thiol (NT), total thiol (TT), disulfide, total antioxidant status, total oxidant status, and ischemia-modified albumin levels were evaluated and compared between groups.Results: A total of 79 children and 74 adults were evaluated in the present study, including 46 children and 40 adults with COVID-19, 33 healthy children, and 34 healthy adults. TT, NT, and disulfide levels were significantly lower in the adult COVID-19 group than in all other groups (p = .001, p = .001, and p = .005, respectively). Additionally, TT and NT levels were significantly lower in both pediatric and adult COVID-19 cases with severe disease course than mild/moderate course. TT and NT levels were identified as predictors for the diagnosis of the adult COVID-19 cases and as independent predictors for disease severity in both children and adults with COVID-19. Conclusion:Parameters that reveal the oxidant and antioxidant capacity, including TT and NT, appear to be good candidates for the accurate prediction of the clinical course among patients with COVID-19.

The potential role of COVID-19 in the induction of DNA damage

“…These results further suggest that in addition to decreased p53 abundance, the functionality of the remaining p53 could be impaired in cells infected by SARS-coronaviruses. Impairment of p53 functions is of particular concern because during severe COVID-19 illness, the patients develop a pro-oxidant state that is also correlated with sustained oxidative DNA damage (discussed below) [ 56 , 57 ], which could increase the probability of a blunted response to DNA damage. Notably, an increase of p53 degradation and the resultant impairment of its normal cell functions are common characteristics of other viruses such as Epstein-Barr virus and human herpes simplex virus-1 [ 52 ].…”

“…Moreover, chronic inflammation is associated with the production of reactive oxygen species that can promote the development of some types of cancer, insulin resistance and vascular lesions [ [77] , [78] , [79] ]. In COVID-19 patients, serum levels of glutathione and total thiol are decreased, while levels of superoxide dismutase, catalase, malondialdehyde (a marker of oxidative stress and lipoperoxidation) and the total oxidant status are increased [ 57 , [80] , [81] , [82] ]. Oxidative stress levels correlated with blood oxygen saturation levels, disease severity, prognosis, and with the virus variant that was causing the infection [ 57 , 80 , 82 , 83 ].…”

“…In COVID-19 patients, serum levels of glutathione and total thiol are decreased, while levels of superoxide dismutase, catalase, malondialdehyde (a marker of oxidative stress and lipoperoxidation) and the total oxidant status are increased [ 57 , [80] , [81] , [82] ]. Oxidative stress levels correlated with blood oxygen saturation levels, disease severity, prognosis, and with the virus variant that was causing the infection [ 57 , 80 , 82 , 83 ]. Mechanistically, an analysis of transcriptome changes observed in different data sets from blood cells, lung biopsies or leukocytes from healthy subjects and COVID-19 patients showed that there is a significant upregulation of pro-oxidant genes, principally the myeloperoxidase and calprotectin genes [ 84 ].…”

Lipid peroxidation as a hallmark of severity in COVID-19 patients

“…Oxidative stress may be a key player in COVID-19 pathogenesis due to its significant role in response to infections [ 7 ]. Several studies have reported some viruses’ ability to disrupt redox balance of a cell to ensure survival [ 8 ].…”

Molecular Mechanisms Related to Responses to Oxidative Stress and Antioxidative Therapies in COVID-19: A Systematic Review

“…On the other side, Aykac et al found that total antioxidant and total oxidant status were similar for both mild, moderate, and severe groups of hospitalized pediatric and adult patients [ 88 ]. Although both studies included a similar number of patients, 96 [ 87 ] and 86 [ 88 ], respectively, it is difficult to compare both studies as they have used different World Health Organization (WHO) interim guidelines for categorization of disease severity, the first from March 2020 [ 87 ] and the second from May 2020 [ 88 ]. Furthermore, there was insufficient data on inclusion and exclusion criteria for patients in the Aykac et al paper [ 88 ].…”