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The Prospective Effect of Allopurinol on the Oxidative Stress Index and Endothelial Dysfunction in Covid-19.
Al-Kuraishy, Hayder M; Al-Gareeb, Ali I; Al-Niemi, Marwa S; Aljowaie, Reem M; Almutairi, Saeedah Musaed; Alexiou, Athanasios; Batiha, Gaber El-Saber.
  • Al-Kuraishy HM; Department of Clinical Pharmacology and Medicine, College of Medicine, AL mustansiriyia University, Bagdad, Iraq.
  • Al-Gareeb AI; Department of Clinical Pharmacology and Medicine, College of Medicine, AL mustansiriyia University, Bagdad, Iraq.
  • Al-Niemi MS; Department of Clinical Pharmacy, College of Pharmacy, Al-Farahidi University, Bagdad, Iraq.
  • Aljowaie RM; Department of Botany and Microbiology, College of Science, King Saud University, P.O. 2455, Riyadh, 11451, Saudi Arabia.
  • Almutairi SM; Department of Botany and Microbiology, College of Science, King Saud University, P.O. 2455, Riyadh, 11451, Saudi Arabia.
  • Alexiou A; Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, Australia. alexiou@ngcef.net.
  • Batiha GE; AFNP Med Austria, Wien, Austria. alexiou@ngcef.net.
Inflammation ; 45(4): 1651-1667, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1709501
ABSTRACT
SARS-CoV-2 by the direct cytopathic effect or indirectly through the propagation of pro-inflammatory cytokines could cause endothelial dysfunction (ED) and oxidative stress (OS). It has been reported that OS is triggered by various types of viral infections, including SARS-CoV-2. Into the bargain, allopurinol is regarded as a potent antioxidant that acts through inhibition of xanthine oxidase (XO), which is an essential enzyme of purine metabolism. Herein, the present study aimed to find the potential protective effects of allopurinol on the biomarkers of OS and ED in patients with severe Covid-19. This single-center cohort study recruited 39 patients with mild-moderate Covid-19 compared with 41 patients with severe Covid-19. Nineteen patients with severe Covid-19 were on the allopurinol treatment because of underlying chronic gout 3 years ago compared with 22 Covid-19 patients not on this treatment. The recruited patients were allocated into three groups group I, mild-moderate Covid-19 on the standard therapy (n = 39); group II, severe Covid-19 patients on the standard therapy only (n = 22); and group III, severe Covid-19 patients on the standard therapy plus allopurinol (n = 19). The duration of the study was 3 weeks from the time of hospitalization till the time of recovery. In addition, inflammatory biomarkers (D-dimer, LDH, ferritin, CRP, procalcitonin), neutrophil-lymphocyte ratio (NLR), endothelin-1 (ET-1), uric acid and oxidative stress index (OSI), CT scan score, and clinical score were evaluated at the time of admission and discharge regarding the effect of allopurinol treatment adds to the standard treatment of Covid-19. Allopurinol plus standard treatment reduced LDH, ferritin, CRP, procalcitonin, and ET-1 serum level significantly (P < 0.05) compared with Covid-19 patients on standard treatment. Besides, neutrophil (%), lymphocyte (%), and neutrophil-lymphocyte ratio (NLR) were reduced in patients with severe Covid-19 on standard treatment plus allopurinol compared with Covid-19 patients on standard treatment alone (P < 0.01). OSI was higher in patients with severe Covid-19 than mild-moderate Covid-19 patients (P = 0.00001) at admission. At the time of discharge, the oxidative status of Covid-19 patients was significantly improved compared with that at admission (P = 0.01). In conclusion, Covid-19 severity is linked with high OS and inflammatory reaction with ED development. High uric acid in patients with severe Covid-19 is correlated with high OS and inflammatory biomarkers. Allopurinol with standard treatment in patients with severe Covid-19 reduced oxidative and inflammatory disorders with significant amelioration of ED and clinical outcomes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Endothelium, Vascular / Allopurinol / Oxidative Stress / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Inflammation Year: 2022 Document Type: Article Affiliation country: S10753-022-01648-7

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Endothelium, Vascular / Allopurinol / Oxidative Stress / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Inflammation Year: 2022 Document Type: Article Affiliation country: S10753-022-01648-7