Plasma Total Antioxidant Capacity and Carbonylated Proteins Are Increased in Pregnant Women with Severe COVID-19

Abstract

Oxidative stress (OS) induced by SARS-CoV-2 infection may play an important role in COVID-19 complications. However, information on oxidative damage in pregnant women with COVID-19 is limited. Objective: We aimed to compare lipid and protein oxidative damage and total antioxidant capacity (TAC) between pregnant women with severe and non-severe COVID-19. Methods: We studied a consecutive prospective cohort of patients admitted to the obstetrics emergency department. All women positive for SARS-CoV-2 infection by reverse transcription-polymerase chain reaction (RT-qPCR) were included. Clinical data were collected and blood samples were obtained at hospital admission. Plasma OS markers, malondialdehyde (MDA), carbonylated proteins (CP), and TAC; angiogenic markers, fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF); and renin-angiotensin system (RAS) markers, angiotensin-converting enzyme 2 (ACE-2) and angiotensin-II (ANG-II) were measured. Correlation between OS, angiogenic, and RAS was evaluated. Results: In total, 57 pregnant women with COVID-19 were included, 17 (28.9%) of which had severe COVID-19; there were 3 (5.30%) maternal deaths. Pregnant women with severe COVID-19 had higher levels of carbonylated proteins (5782 pmol vs. 6651 pmol; p = 0.024) and total antioxidant capacity (40.1 pmol vs. 56.1 pmol; p = 0.001) than women with non-severe COVID-19. TAC was negatively correlated with ANG-II (p < 0.0001) and MDA levels (p < 0.0001) and positively with the sFlt-1/PlGF ratio (p = 0.027). Conclusions: In pregnant women, severe COVID-19 is associated with an increase in protein oxidative damage and total antioxidant capacity as a possible counterregulatory mechanism.

Long-COVID post-viral chronic fatigue syndrome and affective symptoms are associated with oxidative damage, lowered antioxidant defenses and inflammation: a proof of concept and mechanism study

“…Likewise, SARS-Cov-2 infection and acute COVID-19 are accompanied by an inflammatory response 29 , increased MPO activity 35 , indicants of oxidative damage [36][37][38] and increased NO production including increased levels of nitrotyrosine 39 , and lowered antioxidant defenses as indicated by reduced TAC levels 35,39 , Gpx 40 and zinc 41 . Nevertheless, there are no data on whether the effects of the immune-inflammatory processes during acute infection, as indicated by lowered SpO2 and increased body temperature on the physio-affective phenome, are mediated by activated immune and O&NS (IO&NS) pathways.…”

The Impact of Severe COVID-19 on Plasma Antioxidants

“…However, the level of this enzyme was lower in the lungs and has only been detected in some inflammatory cells [17]. In addition, it was suggested that the observed enhancement of total antioxidant capacity (TAC) in pregnant women with COVID-19 may be the body's response to damage to cellular components caused by excess ROS [18]. One of the main consequences of oxidative stress is the modification of physiological lipid metabolism.…”

Biomarkers of endothelial dysfunction are associated with poor outcome in COVID‐19 patients: A systematic review and meta‐analysis

“…In terms of soluble FLT‐1, we included 6 studies 13,48,66,68–70 with 190 patients in poor outcome group and 471 patients in good outcome group. The meta‐analysis derived a pooled standard mean difference of 1.93 (0.65, 3.21) ( p = 0.003).…”

“…Both VEGF and sFLT-1 have previously shown to be associated with sepsis progression, severity and mortality as well as organ dysfunction in these patients. 1,12 Several studies have investigated possible role of these markers in COVID-19 patients and whether they can be used as predictors of severity and mortality of COVID-19 9,13,[66][67][68] . Pine et al…”