Avaliação de condições de admissão e biomarcadores de estresse oxidativo em pacientes internados pela covid-19 em hospital de referência

Abstract

Despite the COVID-19 pandemic showing signs of slowing down, there is still a lack of understanding regarding the progression of the disease. There are indications that oxidative stress from the excess of reactive oxygen species (ROS) and/or the reduction of the antioxidant defense system may be crucial in the clinical outcome, as well as the D-dimer marker at the time of hospital admission may show greater chances of evolution to moderate or severe form of the disease. Thus, the objective of this study was to evaluate at the time of admission of patients with coronavirus disease 2019 (COVID-19) the levels of ROS, non-enzymatic antioxidant reduced glutathione (GSH), D-dimer and their association with clinical severity. This cross-sectional study in which medical records data were collected in the period from March 2020 to December 2021. Information was collected from 170 patients admitted to a reference hospital unit for COVID-19. The mean age of the patients was 59.1 years, with a predominance of males (51.2%). The overall recorded death frequency was 42.35%, 51.17% in moderate patients and 48.83% in severe patients. The mean length of hospital stay was 9.57 days from the onset of symptoms. In the multivariate analysis, patients with Severe Acute Respiratory Syndrome (SARS) were more likely (407%) to present greater severity. With each unit of increase in indirect bilirubin and urea at the time of admission, there was an increase of 274% and 2% in the chance of hospitalization in serious condition, respectively. The results indicate that elevated ROS and D-dimer may contribute to worse outcomes in critically ill patients, demonstrating a potential for specificity and sensitivity as predictors of poor outcome at admission. We recommend future experimental studies to better elucidate the relationship between oxidative stress biomarkers and COVID-19.