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Association of Low Molecular Weight Plasma Aminothiols with the Severity of Coronavirus Disease 2019
Evgeny Vladimirovich Kryukov1, Alexander Vladimirovich Ivanov2, Vladimir Olegovich Karpov1
1Burdenko Main Military Clinical Hospital, Ministry of Defense, Gospitalnaya Sq., 3, 105229 Moscow, Russia.
Insights
Low levels of glutathione (GSH) and cysteinylglycine (CG) are linked to severe COVID-19 and lung damage. Correcting GSH metabolism may offer clinical benefits for COVID-19 patients.
Area of Science:
- Biochemistry
- Immunology
- Infectious Diseases
Background:
- Aminothiols, including glutathione (GSH) and cysteinylglycine (CG), are crucial for cellular redox balance.
- Their role in the pathogenesis and severity of coronavirus disease 2019 (COVID-19) remains under-investigated.
Purpose of the Study:
- To investigate the association between aminothiol levels and COVID-19 severity.
- To explore the relationship between aminothiols and lung injury indicators in COVID-19 patients.
Main Methods:
- Quantification of total (t) and reduced (r) aminothiols (GSH, CG) in COVID-19 patients (n=59) upon admission.
- Lung injury assessment using computed tomography (CT) staging (CT0-4 classification).
Main Results:
- Low total glutathione (tGSH) levels correlated with increased risk of severe COVID-19 (RR=3.09) and lung damage (RR=2.14).
- Reduced cysteinylglycine (rCG) levels were associated with lung damage risk (RR=2.28) and negatively correlated with platelet count.
- Reduced glutathione (rGSH) showed a negative association with D-dimer levels.
Conclusions:
- Total glutathione (tGSH) and reduced cysteinylglycine (rCG) may serve as potential biomarkers for severe COVID-19 risk.
- Glutathione (GSH) plays a role in preventing oxidative damage during infection.
- Modulating glutathione metabolism could be a potential adjunct therapy for COVID-19.
Objective:
Aminothiols (glutathione (GSH), cysteinylglycine (CG)) may play an important role in the pathogenesis of coronavirus disease 2019 (COVID-19), but the possible association of these indicators with the severity of COVID-19 has not yet been investigated.
Methods:
The total content (t) and reduced forms (r) of aminothiols were determined in patients with COVID-19 (n = 59) on admission. Lung injury was characterized by computed tomography (CT) findings in accordance with the CT0-4 classification.
Results:
Low tGSH level was associated with the risk of severe COVID-19 (tGSH ≤ 1.5 μM, mild vs. moderate/severe: risk ratio (RR) = 3.09, p = 0.007) and degree of lung damage (tGSH ≤ 1.8 μM, CT < 2 vs. CT ≥ 2: RR = 2.14, p = 0.0094). The rGSH level showed a negative association with D-dimer levels (ρ = -0.599, p = 0.014). Low rCG level was also associated with the risk of lung damage (rCG ≤ 1.3 μM, CT < 2 vs. CT ≥ 2: RR = 2.28, p = 0.001). Levels of rCG (ρ = -0.339, p = 0.012) and especially tCG (ρ = -0.551, p = 0.004) were negatively associated with platelet count. In addition, a significant relationship was found between the advanced oxidation protein product level and tGSH in patients with moderate or severe but not in patients with mild COVID-19.
Conclusion:
Thus, tGSH and rCG can be seen as potential markers for the risk of severe COVID-19. GSH appears to be an important factor to oxidative damage prevention as infection progresses. This suggests the potential clinical efficacy of correcting glutathione metabolism as an adjunct therapy for COVID-19.
