Do the oxidative stress biomarkers predict COVID-19 outcome? An in-hospital cohort study

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 a-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 a-tocopherol, glutathione, superoxide dismutase, and advanced oxidation protein products differed significantly between survivors and non-survivors. Serum glutathione levels below 327.2 mu mol/ 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]).

Automated summary

Excessive activation of the immune system in SARSCoV-2 infections leads to increased levels of reactive oxygen species, causing damage to cell structures and directly impacting disease severity and mortality. This cohort study evaluated the potential of plasma oxidative stress biomarkers to predict mortality in COVID-19 patients, accounting for confounding factors. The results showed significant differences in serum levels of alpha-tocopherol, glutathione, superoxide dismutase, and advanced oxidation protein products between survivors and non-survivors. Serum glutathione levels below 327.2 μmol/mL were associated with a significantly higher risk of death in COVID-19 patients, independent of other factors (adjusted hazard ratio = 3.12 [95% CI: 1.83-5.33]).