Angiotensin converting enzyme 2 gene expression and markers of oxidative stress are correlated with disease severity in patients with COVID-19.

BACKGROUND: Oxidative stress is thought to play a significant role in the pathogenesis and severity of COVID-19. Additionally, angiotensin converting enzyme 2 (ACE2) expression may predict the severity and clinical course of COVID-19. Accordingly, the aim of the present study was to evaluate the association of oxidative stress and ACE2 expression with the clinical severity in patients with COVID-19. METHODS AND RESULTS: The present study comprised 40 patients with COVID-19 and 40 matched healthy controls, recruited between September 2021 and March 2022. ACE 2 expression levels were measured using Hera plus SYBR Green qPCR kits with GAPDH used as an internal control. Serum melatonin (MLT) levels, serum malondialdehyde (MDA) levels, and total antioxidant capacity (TAC) were estimated using ELISA. The correlations between the levels of the studied markers and clinical indicators of disease severity were evaluated. Significantly, lower expression of ACE2 was observed in COVID-19 patients compared to controls. Patients with COVID-19 had lower serum levels of TAC and MLT but higher serum levels of MDA compared to normal controls. Serum MDA levels were correlated with diastolic blood pressure (DBP), Glasgow coma scale (GCS) scores, and serum potassium levels. Serum MLT levels were positively correlated with DBP, mean arterial pressure (MAP), respiratory rate, and serum potassium levels. TAC was correlated with GCS, mean platelet volume, and serum creatinine levels. Serum MLT levels were significantly lower in patients treated with remdesivir and inotropes. Receiver operating characteristic curve analysis demonstrates that all markers had utility in discriminating COVID-19 patients from healthy controls. CONCLUSIONS: Increased oxidative stress and increased ACE2 expression were correlated with disease severity and poor outcomes in hospitalized patients with COVID-19 in the present study. Melatonin supplementation may provide a utility as an adjuvant therapy in decreasing disease severity and death in COVID-19 patients.

Vitamin C Regulates the Profibrotic Activity of Fibroblasts in In Vitro Replica Settings of Myocardial Infarction.

Extracellular collagen remodeling is one of the central mechanisms responsible for the structural and compositional coherence of myocardium in patients undergoing myocardial infarction (MI). Activated primary cardiac fibroblasts following myocardial infarction are extensively investigated to establish anti-fibrotic therapies to improve left ventricular remodeling. To systematically assess vitamin C functions as a potential modulator involved in collagen fibrillogenesis in an in vitro model mimicking heart tissue healing after MI. Mouse primary cardiac fibroblasts were isolated from wild-type C57BL/6 mice and cultured under normal and profibrotic (hypoxic + transforming growth factor beta 1) conditions on freshly prepared coatings mimicking extracellular matrix (ECM) remodeling during healing after an MI. At 10 µg/mL, vitamin C reprogramed the respiratory mitochondrial metabolism, which is effectively associated with a more increased accumulation of intracellular reactive oxygen species (iROS) than the number of those generated by mitochondrial reactive oxygen species (mROS). The mRNA/protein expression of subtypes I, III collagen, and fibroblasts differentiations markers were upregulated over time, particularly in the presence of vitamin C. The collagen substrate potentiated the modulator role of vitamin C in reinforcing the structure of types I and III collagen synthesis by reducing collagen V expression in a timely manner, which is important in the initiation of fibrillogenesis. Altogether, our study evidenced the synergistic function of vitamin C at an optimum dose on maintaining the equilibrium functionality of radical scavenger and gene transcription, which are important in the initial phases after healing after an MI, while modulating the synthesis of de novo collagen fibrils, which is important in the final stage of tissue healing.

N-Acetyl Cysteine Restores the Diminished Activity of the Antioxidant Enzymatic System Caused by SARS-CoV-2 Infection: Preliminary Findings.

SARS-CoV-2 infects type II pneumocytes and disrupts redox homeostasis by overproducing reactive oxygen species (ROS). N-acetyl cysteine (NAC) is a precursor of the synthesis of glutathione (GSH) and it restores the loss of redox homeostasis associated to viral infections. The aim of the study is to evaluate the effect of the treatment with NAC on the enzymatic antioxidant system in serum from patients infected by SARS-CoV-2. We evaluated the enzymatic activities of thioredoxin reductase (TrxR), glutathione peroxidase (GPx), -S-transferase (GST), and reductase (GR) by spectrophotometry and the concentrations of the glutathione (GSH), total antioxidant capacity (TAC), thiols, nitrites (NO2-), and lipid peroxidation (LPO) in serum. The activity of the extracellular super oxide dismutase (ecSOD) was determined by native polyacrylamide gels, and 3-nitrotyrosine (3-NT) was measured by ELISA. A decrease in the activities of the ecSOD, TrxR, GPx, GST GR, (p = 0 ≤ 0.1), and the GSH, TAC, thiols, and NO2- (p ≤ 0.001) concentrations and an increase in LPO and 3-NT (p = 0.001) concentrations were found in COVID-19 patients vs. healthy subjects. The treatment with NAC as an adjuvant therapy may contribute to a reduction in the OS associated to the infection by SARS-CoV-2 through the generation of GSH. GSH promotes the metabolic pathways that depend on it, thus contributing to an increase in TAC and to restore redox homeostasis.

Interplay between lymphocyte subpopulation, inflammatory cytokines and their correlation with oxidative stress parameters in COVID-19

Our objective was to investigate the inflammatory and oxidative stress markers in patients with moderate and severe form of coronavirus disease 2019 (COVID-19). In addition, we show the correlation between changes in lymphocyte subsets and markers of oxidative stress as a tool for patient classification. Interleukin-6 (IL-6) and VEGF were analyzed by utilizing a High Sensitivity Evidence InvestigatorTM Biochip Array technology. The total antioxidant capacity (PAT) and the free radical concentrations (d-ROM) were measured in serum utilizing analytical photometric system FRAS5. Peripheral blood was used to determine CD45 + mononuclear, B, T, and NK cells using a multi-parameter flow cytometric immunophenotypic test. Statistionly cally significant differences in IL-6 and VEGF levels were observed between the two patient groups. Decreased values of the absolute number of lymphocytes and their CD4 + and CD8 + positive T cells, NK cells, and CD8 were obtained. In the moderate group, good correlations were found between IL-6 and VEGF and NK cells (r=0.6973, P<0.05;for IL-6 and r=0.6498, P<0, for VEGF. 05). Cytokines were correlated with CD45+ (r=0.5610, P<0.05;for IL-6 and r=0.5462, P<0.05 for VEGF). The oxidative stress index can be used as a cheaper alternative and as a triage tool between severe and moderate illnesses, after showing good correlation with more expensive patient classification analysis.Copyright © the Author(s), 2022 Licensee PAGEPress, Italy.

Extraction of Antioxidant Compounds from Brazilian Green Propolis Using Ultrasound-Assisted Associated with Low- and High-Pressure Extraction Methods.

The demand for bee products has been growing, especially regarding their application in complementary medicine. Apis mellifera bees using Baccharis dracunculifolia D.C. (Asteraceae) as substrate produce green propolis. Among the examples of bioactivity of this matrix are antioxidant, antimicrobial, and antiviral actions. This work aimed to verify the impact of the experimental conditions applied in low- and high-pressure extractions of green propolis, using sonication (60 kHz) as pretreatment to determine the antioxidant profile in the extracts. Total flavonoid content (18.82 ± 1.15-50.47 ± 0.77 mgQE·g-1), total phenolic compounds (194.12 ± 3.40-439.05 ± 0.90 mgGAE·g-1) and antioxidant capacity by DPPH (33.86 ± 1.99-201.29 ± 0.31 µg·mL-1) of the twelve green propolis extracts were determined. By means of HPLC-DAD, it was possible to quantify nine of the fifteen compounds analyzed. The results highlighted formononetin (4.76 ± 0.16-14.80 ± 0.02 mg·g-1) and p-coumaric acid (

3D Printing of Functional Strawberry Snacks: Food Design, Texture, Antioxidant Bioactive Compounds, and Microbial Stability.

3D printing technology (3DP) as additive manufacturing is an innovative design technology that can meet the individual nutritional and sensory needs of consumers. Therefore, the aim of this work was to apply 3DP in the production of a strawberry-based functional product with the addition of two hydrocolloids (corn and wheat starch) in three proportions (10, 15 and 20%) and to investigate the influence of 3DP process parameters on physico-chemical and textural properties, as well as the bioactive and antioxidant potential and microbiological stability, with(out) the addition of natural antimicrobial agents. Starch type had a significant effect on all tested bioactive compounds, as well as on starch content, except for total phenolic and hydroxycinnamic acid contents. Considering the content of bioactive compounds and antioxidant capacity, program 2 proved to be more suitable than program 1. All samples exhibited good textural properties, a high degree of stability and minimal geometric deviations. Regarding microbiological safety, no pathogenic bacteria were found in the 3DP samples during storage. The 3DP sample with added citral at a concentration of 75 mg L-1 showed the best microbiological quality. Ultimately, 3DP can be successfully used for the production of new strawberry-based functional products.

Evaluation of interleukin-13 levels and Total Antioxidant Capacity (TAC) in serum of patients with COVID-19 Patients, Cured Patients and Persons Taking Vaccine

The study was designed to evaluate the medical relevance of interleukin-13 levels (ILs-13), and total antioxidant capacity (TAC) in coronavirus disease 2019 (COVID-19) groups, cured groups, control groups;before and after taking the vaccine. Blood samples were taken from Oncology Unit in Al-Mahaweel hospital in Hilla city. Sixteen patients, sixteen cured patients, thirty control, sixteen subject were taken one dose of Pfizer vaccine, and sixteen subject were taken two doses of Pfizer vaccine. We found that significantly with COVID-19 patients Low level mean of IL-13 compar with group (cured patients, receiving dose 1, receiving dose 2), In cured group increase the level of IL13,in groups receiving dose 1, receiving dose 2 high level to mean compared with group Cured patients and Covid-19 patients,total antioxidant capacity (TAC) decreased in patients when compare with the control groups, increase TAC levels in cured patients when compare with COVID-19 patients,, it is found that subjects were taken one dose or tow dose of Pfizer vaccine have more TAC levels than COVID-19 vaccine for that reason the Pfizer vaccines play the important role in activity of immune systems. © 2022, ResearchTrentz Academy Publishing Education Services. All rights reserved.

Evaluation of Total Antioxidant Capacity and Total Oxidant Status in Patients with COVID-19

The COVID-19 is spreading rapidly over the globe disease . A deadly global pandemic of Coronavirus sickness (COVID-19) has caused significant morbidity and mortality in a number of locations. Oxidative stress appears to play a role in COVID-19. The goal of this case-control study was to compare the levels of total antioxidant capacity (TAC), total oxidant status (TOS), and lipid peroxidation products like malondialdehyde (MDA) in the serum of COVID-19 infection patients to a healthy control group, with a scientific interpretation of the results. The data was gathered from (90) participants who were classified into two categories: patients and controls. The CUPRAC procedure evaluates A spectrophotometric reader was used to determine the total oxidant status (TOS). With a p-value of 0.05, the results revealed that there were significant variations in TOS levels between the COVID -19 and control groups (0.009). TAC levels differed significantly between the patient and control groups, with a p-value of (0.012), while TAC levels in the patient group dropped. (1.24+/-0.15), compared to (1.55+/-0.31) in the control group;moreover, oxidative stress is higher in covid-19, with MDA levels of (6.45+/-1.14), compared to (3.22+/-0.69) in the control group, with a significant p-value (0.002). Conclusion(s): Based on the data, it seems that levels of (MDA) are higher in the COVID-19 group than in the control group due to Infection with a virus and a storm of the immune system In addition to acting as an anti-inflammatory mediator, (MDA) is a biomarker for lipid peroxidation, and an increase in free radicals causes oxidative stress, resulting in an increase in (MDA) levels. (TAC) levels were also lower in patients than in the control group, and our findings revealed that patients had higher (TOS) levels than the control group. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Oxidative Stress Markers and Sperm DNA Fragmentation in Men Recovered from COVID-19.

SARS-CoV-2 negatively affects semen characteristics, impairs various biochemical processes in seminal fluid and within spermatogenic cells ultimately leading to male fertility decline. However, the distinct mechanisms, in particular, the role of oxidative stress on the consequences of coronavirus infection, have not been well investigated, which is the purpose of the present study. The standard semen parameters, its pro- and antioxidant system state, as well as the level of sperm DNA fragmentation, were assessed in 17 semen samples of men five months after the coronavirus infection and in 22 age-matched control patients. We determined that the DNA fragmentation rate negatively correlated with the period after coronavirus recovery, as well as seminal fluid superoxide dismutase activity and uric acid level. It was demonstrated that COVID-19 is not always associated with increased DNA fragmentation, allowing them to be considered as two independent factors. Thus, the most significant changes were noted in the samples of men after COVID-19 and abnormal TUNEL results: increased round cell number, decreased seminal fluid's nitrotyrosine level, and total antioxidant capacity and Zn, as well as an increased 8-hydroxy-2'-deoxyguanosine level within spermatozoa. The data obtained indicate that increased DNA fragmentation and diminished semen quality in men can be the result of an imbalance in semen pro- and antioxidant components after COVID-19.

Valorization of Aloe barbadensis Miller. (Aloe vera) Processing Waste

Aloe vera plant is known worldwide for its medicinal properties and application in gel-based products such as shampoo, soap, and sunscreen. However, the demand for these gel-based products has led to a surplus production of Aloe vera processing waste. An Aloe vera gel processing facility could generate up to 4000 kg of Aloe vera waste per month. Currently the Aloe vera waste is being disposed to the landfill or used as fertilizer. A sustainable management system for the Aloe vera processing waste should be considered, due to the negative societal and environmental impacts of the currents waste disposal methods. Therefore, this review focuses on various approaches that can be used to valorize Aloe vera waste into value-added products, such as animal and aquaculture feeds, biosorbents, biofuel and natural polymers. Researchers have reported Aloe vera waste for environmental applications biosorbents used for wastewater treatment of various pollutants. Several studies have also reported on the valorization of Aloe vera waste for production of biofuels such as bioethanol, mixed alcohol fuels, biogas and syngas. Aloe vera waste could also be valorized through isolation and synthesis of natural polymers for application in wound dressing, tissue engineering and drug delivery systems. Aloe vera waste valorization was also reviewed through extraction of value-added bioactive compounds such as aloe-emodin, aloin and aloeresin. These value-added bioactive compounds have various applications in the cosmetics (non-steroidal anti-inflammatory, tyrosinase inhibitors) and pharmaceutical (anticancer agent and COVID 19 inhibitors) industry.

Multiplex Testing of Oxidative-Reductive Pathway in Patients with COVID-19.

Infection with SARS-CoV-2, the causative agent of COVID-19, causes numerous cellular dysfunctions. The virus enters the host cells and hijacks the cell machinery for its replication, resulting in disturbances of the oxidative, reductive balance, increased production of damaging reactive oxygen species (ROS), and mitochondrial dysfunction. This damaging cycle can make cells less resistant to infection and make the host more likely to experience a severe disease course. Treatment with antioxidants has been tested as a potential approach to reduce the effects of this disorder. Here, we present a protocol to assess the impact of treatment with a mixture of curcuminoids on physiological and molecular biomarkers, focusing on determining total antioxidant capacity. We used a cohort of diabetes patients with an imbalance in redox mechanisms as such patients are more likely to become severely ill from COVID-19 than healthy persons.

Performance of Thermoplastic Extrusion, Germination, Fermentation, and Hydrolysis Techniques on Phenolic Compounds in Cereals and Pseudocereals.

Bioactive compounds, such as phenolic compounds, are phytochemicals found in significant amounts in cereals and pseudocereals and are usually evaluated by spectrophotometric (UV-VIS), HPLC, and LC-MS techniques. However, their bioavailability in grains is quite limited. This restriction on bioavailability and bioaccessibility occurs because they are in conjugated polymeric forms. Additionally, they can be linked through chemical esterification and etherification to macro components. Techniques such as thermoplastic extrusion, germination, fermentation, and hydrolysis have been widely studied to release phenolic compounds in favor of their bioavailability and bioaccessibility, minimizing the loss of these thermosensitive components during processing. The increased availability of phenolic compounds increases the antioxidant capacity and favor their documented health promoting.

Oxidative Stress and Inflammatory Status in COVID-19 Outpatients: A Health Center-Based Analytical Cross-Sectional Study.

The antioxidant system can be critical in reducing exacerbated inflammation in COVID-19. This study compared the antioxidant and inflammatory responses between COVID-19 outpatients and seemingly healthy individuals. This descriptive-analytical cross-sectional study was conducted on 53 COVID-19 outpatients and 53 healthy individuals as controls. The serum concentrations of amyloid A (SAA), total antioxidant capacity (TAC), superoxide dismutase (SOD), and glutathione peroxidase (GPx) were measured and compared between COVID-19 patients and controls using the independent sample t-test before and after controlling for dietary supplement use. A generalized estimating equation (GEE) regression model, limited to COVID-19 patients, was used to evaluate the odds ratios (ORs) and 95% confidence intervals (95% CIs) of disease symptoms on days 1, 7, 14, 21, and 28 after the disease onset. Serum concentrations of SOD (p ≤ 0.001) and GPx (p = 0.001) were significantly higher in COVID-19 patients than in controls before adjustment for dietary supplement use. GPx remained significantly higher among COVID-19 patients than in controls after adjustment for all dietary supplements (p = 0.005). Moreover, serum concentrations of GPx (p = 0.003), SOD (p = 0.022), and TAC (p = 0.028) remained significantly higher among COVID-19 patients than in controls after adjustment for vitamin D supplementation. This study showed higher GPx in COVID-19 outpatients than in controls after adjustment for dietary supplement use. Moreover, elevated SOD, GPx, and TAC concentrations were shown in COVID-19 outpatients compared to controls after adjusting for vitamin D supplementation. These results may provide a useful therapeutic target for treating oxidative stress in COVID-19 disease, which may help ameliorate the pandemic.

Kombucha - An ancient fermented beverage with desired bioactivities: A narrowed review.

Kombucha, originated in China 2000  years ago, is a sour and sweet-tasted drink, prepared traditionally through fermentation of black tea. During the fermentation of kombucha, consisting of mainly acidic compounds, microorganisms, and a tiny amount of alcohol, a biofilm called SCOBY forms. The bacteria in kombucha has been generally identified as Acetobacteraceae. Kombucha is a noteworthy source of B complex vitamins, polyphenols, and organic acids (mainly acetic acid). Nowadays, kombucha is tended to be prepared with some other plant species, which, therefore, lead to variations in its composition. Pre-clinical studies conducted on kombucha revealed that it has desired bioactivities such as antimicrobial, antioxidant, hepatoprotective, anti-hypercholestorelomic, anticancer, anti-inflammatory, etc. Only a few clinical studies have been also reported. In the current review, we aimed to overhaul pre-clinical bioactivities reported on kombucha as well as its brief compositional chemistry. The literature data indicate that kombucha has valuable biological effects on human health.

Herbal medications and natural products for patients with covid-19 and diabetes mellitus: Potentials and challenges.

Background: The presence of diabetes mellitus (DM) among COVID-19 patients is associated with increased hospitalization, morbidity, and mortality. Evidence has shown that hyperglycemia potentiates SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection and plays a central role in severe COVID-19 and diabetes comorbidity. In this review, we explore the therapeutic potentials of herbal medications and natural products in the management of COVID-19 and DM comorbidity and the challenges associated with the preexisting or concurrent use of these substances. Methods: Research papers that were published from January 2016 to December 2021 were retrieved from PubMed, ScienceDirect, and Google Scholar databases. Papers reporting clinical evidence of antidiabetic activities and any available evidence of the anti-COVID-19 potential of ten selected natural products were retrieved and analyzed for discussion in this review. Results: A total of 548 papers (73 clinical trials on the antidiabetic activities of the selected natural products and 475 research and review articles on their anti-COVID-19 potential) were retrieved from the literature search for further analysis. A total of 517 articles (reviews and less relevant research papers) were excluded. A cumulative sum of thirty-one (31) research papers (20 clinical trials and 10 others) met the criteria and have been discussed in this review. Conclusion: The findings of this review suggest that phenolic compounds are the most promising phytochemicals in the management of COVID-19 and DM comorbidity. Curcumin and propolis have shown substantial evidence against COVID-19 and DM in humans and are thus, considered the best potential therapeutic options.

Vinegar Production from Corinthian Currants Finishing Side-Stream: Development and Comparison of Methods Based on Immobilized Acetic Acid Bacteria.

Fruit wastes and side-streams can be used for vinegar production to create added value for the agri-food sector and enhance farmer incomes and local economies. In this study, methods for vinegar production by wild and selected acetic acid bacteria (the quick starter Acetobacter aceti and the acid-resistant Komagataeibacter europaeus), free (FC) and immobilized (IC) on a natural cellulosic carrier, are proposed using sweet wine made from the industrial finishing side-stream (FSS) of Corinthian currants as raw material. The results showed all cultures can produce vinegar with 46.65 ± 5.43 g/L acidity, from sweet FSS wine containing 5.08 ± 1.19% alcohol. The effect of immobilization was more obvious in the case of the selected culture, presenting better acetification efficiency, both fresh and after cold storage for 2 months. The vinegars had an antioxidant capacity of 263.5 ± 8.4 and 277.1 ± 6.7 mg/L (as ascorbic acid) and phenolic content 333.1 ± 12.0 and 222.2 ± 2.9 mg/L (as gallic acid) (for FC and IC, respectively). They also had a rich volatilome (140 compounds identified by SPME GC-MS), with higher percentages of esters identified in vinegars made by IC. The results are encouraging for vinegar production with IC of a mixed A. aceti and K. europaeus culture.

Potential Antioxidant and Anti-Inflammatory Properties of Serum from Healthy Adolescents with Optimal Mediterranean Diet Adherence: Findings from DIMENU Cross-Sectional Study.

During adolescence, health status is influenced by several factors, among which dietary pattern is a crucial element of lifestyle in terms of prevention and treatment of metabolic and chronic diseases. The most studied healthy dietary pattern is the Mediterranean Diet (MD), due to a combination of foods that are rich in antioxidant and anti-inflammatory nutrients. The aim of this study, carried out in healthy adolescents from the DIMENU study, is to assess the adherence to the MD, as well as the dietary nutrient intake and to evaluate the potential antioxidant and anti-inflammatory properties of sera from participants grouped according to the MD score. Using the KIDMED score, as the MD quality index for children and teenagers, we found that the adolescents in this study had an average adherence to the MD (6.71 ± 2.58). Adolescents were clustered into three groups based on their MD adherence. Assessment of quality by 24 h recall revealed higher intakes in polyunsaturated fatty acid (PUFA)/saturated fatty acid (SFA) ratio, dietary fibers, vitamins, and total oxygen radical absorbance capacity (ORAC) in the optimal than in poor MD adherence group. We observed that dietary PUFA/SFA ratio was negatively correlated with serum C-Reactive Protein levels, and total dietary fibers were inversely correlated with Erythrocyte Sedimentation Rate values, while total ORAC was directly correlated with serum glucose concentrations. Interestingly, the reactive oxygen metabolite (ROM) concentrations, determined by the ROM assay, were significantly lower in pooled sera from optimal than poor adherers. Finally, using lipopolysaccharide-stimulated human macrophages, as an in vitro model of acute inflammation, we found a reduced secretion of pro-inflammatory cytokines upon serum treatment from adolescents with optimal respect to medium and poor MD adherence. Our results highlight the anti-inflammatory and antioxidant properties of serum from adolescents with healthy nutrition in terms of adherence to the MD, which may have a positive impact on the prevention of chronic diseases in adulthood.

Evaluation of oxidative stress level: total antioxidant capacity, total oxidant status and glutathione activity in patients with COVID-19.

Coronavirus disease 2019 (COVID-19), as a dangerous global pandemic, has led to high morbidity and mortality in all countries. There is a lot of evidence for the possible role of oxidative stress in COVID-19. In the present study, we aimed to measure the levels of glutathione (GSH), total antioxidant capacity (TAC) and total oxidant status (TOS) in the serum of patients with COVID-19. A total of 96 individuals with and without COVID-19 were enrolled and divided into four groups, including hospitalised group in non-intensive care units (non-ICU) (n = 35), hospitalised group in intensive care units with endotracheal intubation (EI) (ICU with EI) (n = 19), hospitalised group in intensive care units without endotracheal intubation (ICU without EI) (n = 24) and healthy people without COVID-19 disease as our control group (n = 18). The present study revealed that the TOS level was significantly lower in the group of control (p = 0.001), and level of GSH remarkably increased in the patients' groups (p < 0.001). TAC activity in non-ICU group of patients had no significant difference in comparison with the control group. However, in hospitalised patients' groups in the ICU with and without EI this activity was significantly different from the control group (p < 0.001). Moreover, there was a significant relationship between the levels of TOS, GSH and TAC with blood oxygen saturation (SpO2), fever, duration of hospitalisation and the prognosis of this disease (p < 0.001). Area under the curve (CI, 95%) of TOS, TAC and GSH-C to predict death among patients were, respectively, 0.907 (0.841, 0.973), 0.735 (0.626, 0.843) and 0.820 (0.725, 0.914). Receiver operating characteristic curve analysis showed that TOS, TAC and GSH-C have the potential specificity and sensitivity to distinguish between alive and dead patients. We found that elevated levels of oxidative stress and reduction of antioxidant indices can aggravate disease's severity in hospitalised patients with COVID-19. Therefore, it can be suggested to apply antioxidant agents as one of the effective therapeutic strategies in these groups.

Interplay between oxidative damage, the redox status, and metabolic biomarkers during long-term fasting.

Obesity and its related metabolic disorders, as well as infectious diseases like covid-19, are important health risks nowadays. It was recently documented that long-term fasting improves metabolic health and enhanced the total antioxidant capacity. The present study investigated the influence of a 10-day fasting on markers of the redox status in 109 subjects. Reducing power, 2,2'-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt radical cation(ABTS) radical scavenging capacity, and hydroxyl radical scavenging capacity increased significantly, and indicated an increase of circulating antioxidant levels. No differences were detected in superoxide scavenging capacity, protein carbonyls, and superoxide dismutase when measured at baseline and after 10 days of fasting. These findings were concomitant to a decrease in blood glucose, insulin, glycated hemoglobin (HbA1c), total cholesterol, low-density lipoprotein (LDL) and triglycerides as well as an increase in total cholesterol/high-density lipoprotein (HDL) ratio. In addition, the well-being index as well as the subjective energy levels increased, documenting a good tolerability. There was an interplay between redox and metabolic parameters since lipid peroxidation baseline levels (thiobarbituric acid reactive substances [TBARS]) affected the ability of long-term fasting to normalize lipid levels. A machine learning model showed that a combination of antioxidant parameters measured at baseline predicted the efficiency of the fasting regimen to decrease LDL levels. In conclusion, it was demonstrated that long-term fasting enhanced the endogenous production of antioxidant molecules, that act protectively against free radicals, and in parallel improved the metabolic health status. Our results suggest that the outcome of long-term fasting strategies could be depending on the baseline values of the antioxidative and metabolic status of subjects.