Assessment of oxidative stress markers in elderly patients with SARS-CoV-2 infection and potential prognostic implications in the medium and long term

  1. Nestor Vazquez-Agra
  2. Ana-Teresa Marques-Afonso
  3. Anton Cruces-Sande
  4. Ignacio Novo-Veleiro
  5. Antonio Pose-Reino
  6. Estefania Mendez-Alvarez
  7. Ramon Soto-Otero
  8. Alvaro Hermida-Ameijeiras

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Abstract

We aimed to evaluate the correlation of plasma levels of thiobarbituric acid reactive substances (TBARS) and reduced thiols with morbidity, mortality and immune response during and after SARS-CoV-2 infection. This was an observational study that included inpatients with SARS-CoV-2 infection older than 65 years. The individuals were followed up to the twelfth month post-discharge. Plasma levels of TBARS and reduced thiols were quantified as a measure of lipid and protein oxidation, respectively. Fatal and non-fatal events were evaluated during admission and at the third, sixth and twelfth month post-discharge. Differences in oxidative stress markers between the groups of interest, time to a negative RT-qPCR and time to significant anti-SARS-CoV-2 IgM titers were assessed. We included 61 patients (57% women) with a mean age of 83 years old. After multivariate analysis, we found differences in TBARS and reduced thiol levels between the comparison groups in fatal and non-fatal events during hospital admission. TBARS levels were also correlated with fatal events at the 6 th and 12 th months post-discharge. One year after hospital discharge, other predictors rather than oxidative stress markers were relevant in the models. The median time to reach significant anti-SARS-CoV-2 IgM titers was lower in patients with low levels of reduced thiols. Assessment of some parameters related to oxidative stress may help identify groups of patients with a higher risk of morbidity, mortality and delayed immune response during and after SARS-CoV-2 infection.

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  1. Version published to 10.1371/journal.pone.0268871
  2. ScreenIT

    SciScore for 10.1101/2022.05.11.22274952: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethical approval: The study was approved by the Research Ethics Committee of Santiago de Compostela-Lugo (2020/578).
    Consent: Informed consent was obtained from all patients for being included in the study.
    Sex as a biological variablenot detected.
    RandomizationPatients were randomly selected from the complete cohort of patients admitted to hospital with SARS-CoV-2 infection.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    The detection of anti-SARS-CoV-2 IgM antibodies was performed by enzyme-linked immunosorbent assay (ELISA) and results were provided quantitatively [23, 24].
    anti-SARS-CoV-2 IgM
    suggested: (Bethyl Cat# E88-302, RRID:AB_2892019)
    Software and Algorithms
    SentencesResources
    Statistical analysis: Statistical analysis was performed by using SPSS 22.0 statistical software (SPSS Inc, Chicago, IL).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations and strengths: This was a prospective single-center study of real clinical practice carried out in elderly Caucasian patients with SARS-CoV-2 infection from the northwest region of Spain (Galicia) who exhibited similar features than elderly people from the western European countries. Our results should be interpreted with caution when applying them to other population, race or ethnicity. The sample was not the total population of patients admitted for SARS-CoV-2 in the unit, so the results could be susceptible to a certain sampling error. Although patients were evaluated prospectively, baseline clinical and laboratory data were collected at one point during admission, so some changes in these variables may be relevant and provide more information. Assessing comparability between groups on some variables was complicated because of a low frequency of events of interest in some categories, which could make some results less accurate. Regarding the results, we found that younger patients with lower body weight had higher mortality, although it is known that they were patients with a higher degree of cognitive impairment who were probably in a poorer nutritional status. On the other hand, current or former smokers presented a higher number of non-fatal events in some comparison groups. However, in most cases the smoking abuse was stopped more than 10-15 years ago, so a strong implication of that differences on the results would be unlikely. In another vein, the frequen...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2022.05.11.22274952v1 on medRxiv