Susceptibility of the patients infected with Sars-Cov2 to oxidative stress and possible interplay with severity of the disease

Gadotti, Ana Carolina; Lipiński, A; Vasconcellos, Franciane T F; Marqueze, Luis Felipe; Cunha, Eduardo B B; Campos, Ana Cláudia; Oliveira, Carlos; Amaral, Andréa Nm.; Baena, Cristina P; Telles, João Paulo; Tuon, Felipe Francisco; Pinho, Ricardo A.

doi:10.1016/j.freeradbiomed.2021.01.044

Cited by 40 publications

(30 citation statements)

References 54 publications

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“…Muhammad et al [ 24 ] reported that the concentrations of antioxidant molecules (glutathione, glutathione peroxidase, catalase, and superoxide dismutase), antioxidant trace elements (copper, zinc, selenium, and manganese), and vitamins A, C, and E were markedly lower, while the level of 8-iso-prostaglandin F2α, a product of ROS-induced lipid oxidation, was markedly higher in COVID-19 patients compared to healthy controls. On the contrary, a study by Gadotti et al [ 25 ] found no difference in levels of oxidative damage, and oxidant and antioxidant markers between moderate and severe COVID-19 patients. The researchers explained that these unexpected results may be due to the time of sample collection, as the moderate and severe groups were in the critical stage of COVID-19 disease.…”

Section: Discussionmentioning

confidence: 89%

Thiol level and total oxidant/antioxidant status in patients with COVID-19 infection

Çakırca

Üstünel

et al. 2021

Ir J Med Sci

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Background Accumulating evidence suggests that oxidative stress is closely related to the pathogenesis and severity of COVID-19 infection. Here, we attempted to compare thiol, total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) levels between COVID-19 patients who need and do not need intensive care unit (ICU) support, and determine whether these markers could be used as predictors of ICU admission. Methods We recruited 86 patients with COVID-19 infection and classified them into two groups according to the level of care: ICU group ( n = 40) and non-ICU group ( n = 46). Thiol, TAS, TOS, and OSI levels were determined and compared between the two groups. Results The levels of thiol and TAS in serum were markedly lower in ICU patients than in the non-ICU patients. On the contrary, TOS and OSI levels were markedly higher. Inflammatory markers, including white blood cell, neutrophil, C-reactive protein, procalcitonin, and ferritin, were negatively correlated with the thiol and TAS, and positively correlated with the TOS and OSI. We determined that areas under the ROC curve for thiol, TAS, TOS, and OSI were 0.799, 0.778, 0.713, and 0.780, respectively. Conclusions Our results revealed that the increase in oxidative stress and decrease in antioxidant levels in COVID-19-infected patients were associated with worsening of disease. Thiol, TAS, TOS, and OSI parameters can be used to distinguish between ICU patients and those who do not, among which thiol was the best predictor of ICU requirement.

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Section: Discussionmentioning

confidence: 89%

Thiol level and total oxidant/antioxidant status in patients with COVID-19 infection

Çakırca

Üstünel

et al. 2021

Ir J Med Sci

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“…While excessive inflammation plays an important role in aggressive COVID-19, the relevance of this generated oxidative stress is uncertain, mostly due to the short lifetime of free radicals and the complexity of the disease itself [ 21 , 22 , 23 ]. On the other hand, reactive aldehyde HNE, the particular LPO product of PUFAs, which regulates the sensitivity of cells to OS and their adaptation acting as the second messenger of free radicals and a signaling molecule, has a longer lifetime mostly because of high affinity for binding to proteins [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Preliminary Findings on the Association of the Lipid Peroxidation Product 4-Hydroxynonenal with the Lethal Outcome of Aggressive COVID-19

et al. 2021

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Major findings of the pilot study involving 21 critically ill patients during the week after admission to the critical care unit specialized for COVID-19 are presented. Fourteen patients have recovered, while seven passed away. There were no differences between them in respect to clinical or laboratory parameters monitored. However, protein adducts of the lipid peroxidation product 4-hydroxynonenal (HNE) were higher in the plasma of the deceased patients, while total antioxidant capacity was below the detection limit for the majority of sera samples in both groups. Moreover, levels of the HNE-protein adducts were constant in the plasma of the deceased patients, while in survivors, they have shown prominent and dynamic variations, suggesting that survivors had active oxidative stress response mechanisms reacting to COVID-19 aggression, which were not efficient in patients who died. Immunohistochemistry revealed the abundant presence of HNE-protein adducts in the lungs of deceased patients indicating that HNE is associated with the lethal outcome. It seems that HNE was spreading from the blood vessels more than being a consequence of pneumonia. Due to the limitations of the relatively small number of patients involved in this study, further research on HNE and antioxidants is needed. This might allow a better understanding of COVID-19 and options for utilizing antioxidants by personalized, integrative biomedicine approach to prevent the onset of HNE-mediated vitious circle of lipid peroxidation in patients with aggressive inflammatory diseases.

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“…Once the positive response of the phthalocyanine derivative-containing mouthwash in the present study and in previous studies 14 , 15 can be observed, the authors also speculate that other properties of phthalocyanines will be identified. In this sense, the possibilities of the local effect of APD associated with the control of secondary infections (antimicrobial activity), the anti-inflammatory effect, and the modulatory effect on the immune response are not excluded 20 , 21 , 37 , 38 .…”

Section: Discussionmentioning

confidence: 99%

Beneficial effects of a mouthwash containing an antiviral phthalocyanine derivative on the length of hospital stay for COVID-19: randomised trial

Santos

Orcina

Machado

et al. 2021

Sci Rep

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The risk of contamination and dissemination by SARS-CoV-2 has a strong link with nasal, oral and pharyngeal cavities. Recently, our research group observed the promising performance of an anionic phthalocyanine derivative (APD) used in a mouthwash protocol without photoexcitation; this protocol improved the general clinical condition of patients infected with SARS-CoV-2. The present two-arm study evaluated in vitro the antiviral activity and cytotoxicity of APD. Additionally, a triple-blind randomized controlled trial was conducted with 41 hospitalized patients who tested positive for COVID-19. All the included patients received World Health Organization standard care hospital treatment (non-intensive care) plus active mouthwash (experimental group AM/n = 20) or nonactive mouthwash (control group NAM/n = 21). The adjunct mouthwash intervention protocol used in both groups consisted one-minute gargling/rinsing / 5 times/day until hospital discharge. Groups were compared considering age, number of comorbidities, duration of symptoms prior admission and length of hospital stay (LOS). The associations between group and sex, age range, presence of comorbidities, admission to Intensive care unit (ICU) and death were also evaluated. The in vitro evaluation demonstrated that APD compound was highly effective for reduction of SARS-CoV-2 viral load in the 1.0 mg/mL (99.96%) to 0.125 mg/mL (92.65%) range without causing cytotoxicity. Regarding the clinical trial, the median LOS of the AM group was significantly shortened (4 days) compared with that of the NAM group (7 days) (p = 0.0314). Additionally, gargling/rinsing with APD was very helpful in reducing the severity of symptoms (no ICU care was needed) compared to not gargling/rinsing with APD (28.6% of the patients in the NAM group needed ICU care, and 50% of this ICU subgroup passed way, p = 0.0207). This study indicated that the mechanical action of the protocol involving mouthwash containing a compound with antiviral effects against SARS-CoV-2 may reduce the symptoms of the patients and the spread of infection. The use of APD in a mouthwash as an adjuvant the hospital COVID-19 treatment presented no contraindication and reduced the hospital stay period.Trial registration: The clinical study was registered at REBEC—Brazilian Clinical Trial Register (RBR-58ftdj).

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Susceptibility of the patients infected with Sars-Cov2 to oxidative stress and possible interplay with severity of the disease

Cited by 40 publications

References 54 publications

Thiol level and total oxidant/antioxidant status in patients with COVID-19 infection

Thiol level and total oxidant/antioxidant status in patients with COVID-19 infection

Preliminary Findings on the Association of the Lipid Peroxidation Product 4-Hydroxynonenal with the Lethal Outcome of Aggressive COVID-19

Beneficial effects of a mouthwash containing an antiviral phthalocyanine derivative on the length of hospital stay for COVID-19: randomised trial

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