COVID-19 Hastalarında Serum Nitrik Oksit Düzeylerindeki Değişiklikler

Öz

Amaç: Tüm dünyayı gerek sağlık gerekse ekonomik açıdan hızla olumsuz etkileyen COVID-19 pandemisinin etyolojik ajanı Coronavirüs 2 (SARS-CoV-2), beta koronavirüs ailesindendir. COVID-19 hastalarında oksidatif stres dengesizliği meydana gelmesine rağmen, değişen nitrik oksit (NO) seviyelerinin COVID-19 patogenezini nasıl etkilediği tam olarak anlaşılmamıştır. Bu amaçla COVID-19 hasta serumlarında NO düzeyleri değerlendirildi. Gereç ve Yöntem: Çalışmaya toplam 50 yetişkin COVID-19 hastası ve 32 sağlıklı kontrol birey dahil edildi. COVID-19 hastaları ulusal kılavuzlara göre Hafif-COVID-19, Orta-COVID-19 ve Yoğun Bakım-COVID-19 olmak üzere sınıflandırıldı. Tüm hastaların serum örneklerinden NO konsantrasyonları spektrofotometrik olarak ölçüldü. Ek olarak biyokimyasal verileri toplandı. Bulgular: Sonuç olarak NO düzeyleri hasta grupta kontrol grubuna göre düşüktü fakat bu düşüklük istatistiksel olarak anlamlı değildi (p>0.05). Sonuç: NO düzeylerindeki değişkenlik COVID-19 hastalarında immün inflamasyon ve vasküler disfonksiyonun bir sonucu olarak ortaya çıkabileceğini düşündürtmektedir.

Anahtar Kelimeler

• COVID-19
• Serbest Radikal
• Nitrik Oksit

Changes in Serum Nitric Oxide Levels in COVID-19 Patients

Öz

Aim: The etiological agent of the COVID-19 pandemic, which has rapidly negatively affected the whole world in terms of both health and economy, is Coronavirus 2 (SARS-CoV-2), a member of the beta coronavirus family. Although oxidative stress imbalance occurs in COVID-19 patients, how altered nitric oxide (NO) levels affect COVID-19 pathogenesis is not fully understood. For this purpose, NO levels were evaluated in COVID-19 patient serum sampels. Materials and Methods: A total of 50 adult COVID-19 patients and 32 healthy control individuals were included in the study. COVID-19 patients were classified as Mild-COVID-19, Modarete-COVID-19 and ICU-COVID-19 according to national guidelines. NO concentrations were measured spectrophotometrically from the serum samples of all patients. Additionally, biochemical data were collected. Results: As a result, NO levels were lower in the patient group compared to the control group, but this decrease was not statistically significant (p>0.05). Conclusion: Variability in NO levels suggests that it may occur as a result of immune-inflammation and vascular dysfunction in COVID-19 patients.

Anahtar Kelimeler

• COVID-19;
• Free Radical;
• Nitric Oxide

Kaynakça

1. 1. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3):105924.
2. 2. Wang LF, Shi Z, Zhang S, Field H, Daszak P, Eaton BT. Review of bats and SARS. Emerg Infect Dis. 2006;12(12):1834-40.
3. 3. WHO. Coronavirus disease (COVID-19) Pandemic. 2020.https:// www.who.int/emergencies/diseases/novel-coronavirus-2019/ (Access date: 03.04.2023).
4. 4. Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. 2020;30(8):4381-9.
5. 5. Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417-8.
6. 6. Ntyonga-Pono MP. COVID-19 infection and oxidative stress: an under-explored approach for prevention and treatment? Pan Afr Med J. 2020;35(Suppl 2):12.
7. 7. Derouiche S. Oxidative stress associated with SARS-Cov-2 (COVID-19) increases the severity of the lung disease a systematic review. J Infect Dis Epidemiol. 2020;6(3):121.
8. 8. Schönrich G, Raftery MJ, Samstag Y. Devilishly radical NETwork in COVID-19: Oxidative stress, neutrophil extracellular traps (NETs), and T cell suppression. Adv Biol Regul. 2020;77:100741.

9. 9. Delgado-Roche L, Mesta F. Oxidative Stress as Key Player in Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) Infection. Arch Med Res. 2020;51(5):384-7.
10. 10. Furchgott RF, Zawadzki JV. The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature. 1980 Nov 27;288(5789):373-6.
11. 11. Lowenstein CJ, Dinerman JL, Snyder SH. Nitric oxide: a physiologic messenger. Ann Intern Med. 1994;120(3):227-37.
12. 12. Marongoz C. Nitrik Oksit ve Deneysel epilepsi. O.M.Ü. Tıp Dergisi. 1996;13(3):165-83.
13. 13. Mandal SM. Nitric oxide mediated hypoxia dynamics in COVID-19. Nitric Oxide. 2023;133:18-21.
14. 14. Yamasaki H. Blood nitrate and nitrite modulating nitric oxide bioavailability: Potential therapeutic functions in COVID-19. Nitric Oxide. 2020;103:29-30.
15. 15. Green SJ. Covid-19 accelerates endothelial dysfunction and nitric oxide deficiency. Microbes Infect. 2020;22(4-5):149-50.
16. 16. Alamdari DH, Moghaddam AB, Amini S, Kerameti MR, Zermehri AM, Alamdari AH et al. Application of methylene blue -vitamin C -N-acetyl cysteine for treatment of critically ill COVID-19 patients, report of a phase-I clinical trial. Eur J Pharmacol. 2020; 885:173494.
17. 17. Kleinbongard P, Dejam A, Lauer T, Rassaf T, Schindler A, Picker O et al. Plasma nitrite reflects constitutive nitric oxide synthase activity in mammals. Free Radic Biol Med. 2003;35:790-6.
18. 18. Mete AÖ, Koçak K, Saracaloglu A, Demiryürek S, Altınbaş Ö, Demiryürek AT. Effects of antiviral drug therapy on dynamic thiol/ disulphide homeostasis and nitric oxide levels in COVID-19 patients. Eur J Pharmacol. 2021;907:174306.
19. 19. Ozdemir B, Yazici A. Could the decrease in the endothelial nitric oxide (NO) production and NO bioavailability be the crucial cause of COVID-19 related deaths? Med Hypotheses. 2020;144:109970.
20. 20. Fang W, Jiang J, Su L, Shu T, Liu H, Lai S et al. The role of NO in COVID-19 and potential therapeutic strategies. Free Radic Biol Med. 2021;163:153-62.