Abstract
Oxidative stress has been implicated to play a critical role in the pathophysiology of coronavirus disease 2019 (COVID-19) and may therefore be considered as a relevant therapeutic target. Serum free thiols (R-SH, sulfhydryl groups) comprise a robust marker of systemic oxidative stress, since they are readily oxidized by reactive oxygen species (ROS). In this study, serum free thiol concentrations were measured in hospitalized and non-hospitalized patients with COVID-19 and healthy controls and their associations with relevant clinical parameters were examined. Serum free thiol concentrations were measured colorimetrically (Ellman’s method) in 29 non-hospitalized COVID-19 subjects and 30 age-, sex-, and body-mass index (BMI)-matched healthy controls and analyzed for associations with clinical and biochemical disease parameters. Additional free thiol measurements were performed on seven serum samples from COVID-19 subjects who required hospitalization to examine their correlation with disease severity. Non-hospitalized subjects with COVID-19 had significantly lower concentrations of serum free thiols compared to healthy controls (p = 0.014), indicating oxidative stress. Serum free thiols were positively associated with albumin (St. β = 0.710, p < 0.001) and inversely associated with CRP (St. β = −0.434, p = 0.027), and showed significant discriminative ability to differentiate subjects with COVID-19 from healthy controls (AUC = 0.69, p = 0.011), which was slightly higher than the discriminative performance of CRP concentrations regarding COVID-19 diagnosis (AUC = 0.66, p = 0.042). This study concludes that systemic oxidative stress is increased in patients with COVID-19 compared with healthy controls. This opens an avenue of treatment options since free thiols are amenable to therapeutic modulation.
Highlights
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing pandemic that continues its morbidity and mortality rates to mount globally
We examined the association between serum free thiol concentrations—as a biomarker for systemic oxidative stress—and COVID-19 in a cohort primarily consisting of non-hospitalized individuals
We found an independent association between serum free thiol concentrations and albumin concentrations in both COVID-19 subjects and healthy controls
Summary
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing pandemic that continues its morbidity and mortality rates to mount globally. Antioxidants 2021, 10, 2022 the majority of individuals, some patients may develop severe pulmonary and systemic disease with clinical scenarios of acute respiratory distress syndrome (ARDS) and multi-organ failure (MOF) [1]. Oxidative stress has been implicated to play a pivotal role in COVID-19 pathophysiology and is associated with other underlying mechanisms involved, including hyperinflammation, coagulopathy, and hypoxia [2,3]. Severe COVID-19 is marked by extensive inflammatory pathology that can affect various organs within the body. Immune cell infiltration leads to the reduction of antioxidants and to the production of reactive oxygen species (ROS) that are thought to induce an inflammation-driven oxidative storm in COVID-19, thereby altering the redox balance
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