A Pilot Study on Oxidative Stress during the Recovery Phase in Critical COVID-19 Patients in a Rehabilitation Facility: Potential Utility of the PAOT® Technology for Assessing Total Anti-Oxidative Capacity

Joël Pincemail; Anne-Françoise Rousseau; Jean-François Kaux; Jean-Paul Cheramy-Bien; Christine Bruyère; Jeanine Prick; David Stern; Mouna-Messaouda Kaci; Benoît Maertens De Noordhout; Adelin Albert; Céline Eubelen; Caroline Le Goff; Benoît Misset; Etienne Cavalier; Corinne Charlier; Smail Meziane

doi:10.3390/biomedicines11051308

A Pilot Study on Oxidative Stress during the Recovery Phase in Critical COVID-19 Patients in a Rehabilitation Facility: Potential Utility of the PAOT^® Technology for Assessing Total Anti-Oxidative Capacity

Biomedicines. 2023 Apr 28;11(5):1308. doi: 10.3390/biomedicines11051308.

Authors

Joël Pincemail¹, Anne-Françoise Rousseau², Jean-François Kaux³, Jean-Paul Cheramy-Bien⁴, Christine Bruyère³, Jeanine Prick³, David Stern⁵, Mouna-Messaouda Kaci⁶, Benoît Maertens De Noordhout³, Adelin Albert⁷, Céline Eubelen³, Caroline Le Goff¹, Benoît Misset², Etienne Cavalier¹, Corinne Charlier⁸, Smail Meziane⁶

Affiliations

¹ Clinical Chemistry, University Hospital of Liège, Sart Tilman, 4000 Liège, Belgium.
² Intensive Care Department, University Hospital of Liège, Sart Tilman, 4000 Liège, Belgium.
³ Physical Medicine Rehabilitation and Sports Traumatology Department Sports, University Hospital of Liège, Sart Tilman, 4000 Liège, Belgium.
⁴ Department of Cardiovascular Surgery, University Hospital of Liège, Sart Tilman, 4000 Liège, Belgium.
⁵ Veterinary Medicine Faculty, FARAH, University of Liège, Sart Tilman, 4000 Liège, Belgium.
⁶ Research Department, Institut Européen des Antioxydants (IEA), Oxystress Technologies PAOTScan, 54500 Vandœuvre-lès-Nancy, France.
⁷ Biostatistics Department, University Hospital of Liège, Sart Tilman, 4000 Liège, Belgium.
⁸ Toxicology Department, University Hospital of Liège, Sart Tilman, 4000 Liège, Belgium.

Abstract

Background: Oxidative stress (OS) could cause various COVID-19 complications. Recently, we have developed the Pouvoir AntiOxydant Total (PAOT®) technology for reflecting the total antioxidant capacity (TAC) of biological samples. We aimed to investigate systemic oxidative stress status (OSS) and to evaluate the utility of PAOT® for assessing TAC during the recovery phase in critical COVID-19 patients in a rehabilitation facility.

Materials and methods: In a total of 12 critical COVID-19 patients in rehabilitation, 19 plasma OSS biomarkers were measured: antioxidants, TAC, trace elements, oxidative damage to lipids, and inflammatory biomarkers. TAC level was measured in plasma, saliva, skin, and urine, using PAOT and expressed as PAOT-Plasma, -Saliva, -Skin, and -Urine scores, respectively. Plasma OSS biomarker levels were compared with levels from previous studies on hospitalized COVID-19 patients and with the reference population. Correlations between four PAOT scores and plasma OSS biomarker levels were analyzed.

Results: During the recovery phase, plasma levels in antioxidants (γ-tocopherol, β-carotene, total glutathione, vitamin C and thiol proteins) were significantly lower than reference intervals, whereas total hydroperoxides and myeloperoxidase (a marker of inflammation) were significantly higher. Copper negatively correlated with total hydroperoxides (r = 0.95, p = 0.001). A similar, deeply modified OSS was already observed in COVID-19 patients hospitalized in an intensive care unit. TAC evaluated in saliva, urine, and skin correlated negatively with copper and with plasma total hydroperoxides. To conclude, the systemic OSS, determined using a large number of biomarkers, was always significantly increased in cured COVID-19 patients during their recovery phase. The less costly evaluation of TAC using an electrochemical method could potentially represent a good alternative to the individual analysis of biomarkers linked to pro-oxidants.

Keywords: blood oxidative stress status; patient rehabilitation; post-COVID-19 pneumonia.

Grants and funding

The authors thank IEA, France for his support and the analysis of all PAOT^®-scores.