Abstract
Major findings of the pilot study involving 21 critically ill patients during the week after admission to the critical care unit specialized for COVID-19 are presented. Fourteen patients have recovered, while seven passed away. There were no differences between them in respect to clinical or laboratory parameters monitored. However, protein adducts of the lipid peroxidation product 4-hydroxynonenal (HNE) were higher in the plasma of the deceased patients, while total antioxidant capacity was below the detection limit for the majority of sera samples in both groups. Moreover, levels of the HNE-protein adducts were constant in the plasma of the deceased patients, while in survivors, they have shown prominent and dynamic variations, suggesting that survivors had active oxidative stress response mechanisms reacting to COVID-19 aggression, which were not efficient in patients who died. Immunohistochemistry revealed the abundant presence of HNE-protein adducts in the lungs of deceased patients indicating that HNE is associated with the lethal outcome. It seems that HNE was spreading from the blood vessels more than being a consequence of pneumonia. Due to the limitations of the relatively small number of patients involved in this study, further research on HNE and antioxidants is needed. This might allow a better understanding of COVID-19 and options for utilizing antioxidants by personalized, integrative biomedicine approach to prevent the onset of HNE-mediated vitious circle of lipid peroxidation in patients with aggressive inflammatory diseases.
Highlights
This article is an open access articleFirst cases of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, were reported at the very end of the year2019
The amounts of the HNE are presented in pmol/mg protein values, while the the asterisk indicates a significant difference (p < 0.05) between the average values determined for the plasma of survivors asterisk indicates a significant difference (p < 0.05) between the average values determined for the plasma of survivors and and for the deceased COVID-19 patients
Reactive aldehyde HNE, the particular lipid peroxidation (LPO) product of PUFAs, which regulates the sensitivity of cells to oxidative stress (OS) and their adaptation acting as the second messenger of free radicals and a signaling molecule, has a longer lifetime mostly because of high affinity for binding to proteins [24,25]
Summary
First cases of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, were reported at the very end of the year. Antioxidants 2021, 10, 1341 by the Food and Drug Administration as appropriate to treat patients with COVID-19, the first vaccines are implemented worldwide according to the urgent criteria, occasionally causing inexplicable side effects. Major complications of severe COVID-19 infection include acute respiratory distress syndrome (ARDS), sepsis, and multiple organ dysfunction or failure (MOF) [1]. Each of these severe disorders is associated with inflammation and excessive generation of reactive oxygen species (ROS), affecting body redox balance, causing oxidative damage of macromolecules under the pathophysiological process of oxidative stress (OS).
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