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Do the oxidative stress biomarkers predict COVID-19 outcome? An in-hospital cohort study
Fabio Fernandes Neves1, Henrique Pott-Junior1, Kaori Maria Carolina Yamashita1
1Department of Medicine, Federal University of São Carlos - UFSCar, 13565-905, São, Carlos, Brazil.
Insights
Low serum glutathione levels predict higher mortality risk in patients with severe Coronavirus Disease 2019 (COVID-19). This finding aids in identifying high-risk individuals for COVID-19 mortality.
Area of Science:
- Biochemistry
- Immunology
- Infectious Diseases
Background:
- SARS-CoV-2 infection triggers excessive immune activation, leading to elevated reactive oxygen species (ROS).
- Increased ROS damages cellular structures and contributes to severe COVID-19 outcomes and mortality.
- Oxidative stress biomarkers may offer predictive value for disease severity and patient prognosis.
Purpose of the Study:
- To investigate the association between plasma oxidative stress biomarker levels and mortality in hospitalized adults with COVID-19.
- To identify specific biomarkers that can predict mortality in COVID-19 patients, considering potential confounding factors.
Main Methods:
- A cohort study involving 115 adults with severe COVID-19 admitted to a Brazilian hospital.
- Quantification of serum biomarkers including α-tocopherol, glutathione, superoxide dismutase, 8-hydroxy-2'-deoxyguanosine, malondialdehyde, and advanced oxidation protein products at diagnosis.
- Statistical analysis to compare biomarker levels between survivors and non-survivors and assess predictive value for mortality.
Main Results:
- Significant differences in serum levels of α-tocopherol, glutathione, superoxide dismutase, and advanced oxidation protein products were observed between survivors and non-survivors.
- Lower serum glutathione levels (below 327.2 μmol/mL) were significantly associated with an increased risk of death.
- The association between low glutathione and mortality remained significant after adjusting for other potential confounding factors (adjusted hazard ratio = 3.12).
Conclusions:
- Plasma oxidative stress biomarkers, particularly glutathione, can serve as predictors of mortality in COVID-19 patients.
- Monitoring glutathione levels may help stratify risk and guide clinical management for severe COVID-19 cases.
- Targeting oxidative stress pathways could be a potential therapeutic strategy to improve outcomes in COVID-19.
Abstract:
In SARSCoV-2 infections, excessive activation of the immune system dramatically elevates reactive oxygen species levels, harms cell structures, and directly increases disease severity and mortality. We aimed to evaluate whether plasma oxidative stress biomarker levels could predict mortality in adults admitted with Coronavirus Disease 2019 (COVID-19), considering potential confounders. We conducted a cohort study of 115 adults (62.1 ± 17.6 years, 65 males) admitted to a Brazilian public hospital for severely symptomatic COVID-19. Serum levels of α-tocopherol, glutathione, superoxide dismutase, 8-hydroxy-2'-deoxyguanosine, malondialdehyde, and advanced oxidation protein products were quantified at COVID-19 diagnosis using real-time polymerase chain reaction. Serum levels of α-tocopherol, glutathione, superoxide dismutase, and advanced oxidation protein products differed significantly between survivors and non-survivors. Serum glutathione levels below 327.2 μmol/mL were associated with a significant risk of death in COVID-19 patients, even after accounting for other factors (adjusted hazard ratio = 3.12 [95% CI: 1.83-5.33]).
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