The Association Between Antioxidants and COVID-19 Outcomes: a Systematic Review on Observational Studies

Abstract

It is proven that the blood concentration of antioxidants can impress the severity of viral infections, including COVID-19. However, the lack of a comprehensive study accumulating existing data regarding COVID-19 can be perceived. Therefore, this systematic review is aimed to report the association between the blood concentration of several antioxidants and the overall health condition of COVID-19 patients. We summarized the available data surrounding the serum antioxidant level in COVID-19 patients and COVID-19 outcomes. A systematic search was performed in PubMed, Scopus, Web of Science, and Cochrane, and studies that evaluated the association between antioxidants and COVID-19 outcomes were included. Of 4101 articles that were viewed in the database search, 38 articles were included after the title, abstract, and full-text review. Twenty-nine studies indicated that lower serum antioxidants are associated with worse outcomes, and one study reported no association between serum zinc (Zn) level and COVID-19 outcomes. In most cases, antioxidant deficiency was associated with high inflammatory factors, high mortality, acute kidney injury, thrombosis, intensive care unit (ICU) admission, acute respiratory distress syndrome, cardiac injury, and the need for mechanical ventilation (MV), and there was no significant association between serum antioxidants level and ICU or hospital length of stay (LOS). It seems that higher levels of antioxidants in COVID-19 patients may be beneficial to prevent disease progression. However, clinical trials are needed to confirm this conclusion. Supplementary Information The online version contains supplementary material available at 10.1007/s12011-023-03588-1.

Pharmacogenomic Landscape of Ivermectin and Selective Antioxidants: Exploring Gene Interplay in the Context of Long COVID

“…Taken together, due to the fact that oxidation, inflammation, and immune response impairment are interconnected and play as key determinants in COVID-19, investigations of the modes of action of antioxidant effects of these compounds in the pharmacogenetic perspective would be of great interest for designing personalized medicines [5]. Moreover, higher levels of antioxidants in COVID-19 patients were found to be beneficial to prevent disease progression in a systematic research evaluating association between antioxidants and COVID-19 outcomes [38]. However, further research is needed to fully understand the effectiveness and appropriate dosages of antioxidants in the context of COVID-19 treatment.…”

“…One of the implementation challenges of pharmacogenomics is to investigate how the genes influence individuals' responses to pharmacological treatments (e.g., minimal dosage for efficacy, and adverse effects) since usually more than one gene is involved in the drug response pathway [38]. Recently, data of 132 pharmacogenomic dosing guidelines for 99 drugs are available from organizations such as the Clinical Pharmacogenetics Implementation Consortium (CPIC) and the Dutch Pharmacogenetics Working Group (DPWG) [38]. In clinical studies, the role of pharmacogenetic analysis is to design personalized medication to optimize drug therapy by ensuring maximum efficacy and minimal adverse effects based on a patient's genotype [56,57].…”

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“…In particular, the infection can present as asymptomatic, symptomatic, or life-threatening and the symptoms of this disease include coughing, fever, dyspnea, anosmia, and myalgia. 1 , 2 Several factors are associated with poor outcomes and increased risk of mortality such as older age, obesity, diabetes mellitus, hypertension, chronic kidney disease, and cancer. COVID-19 enters human cells via its binding to Human Angiotensin Receptor Enzyme 2 (hACE2) which functions as a receptor for this virus.…”