Perfil clínico, oxidativo e inflamatório em pacientes com SARS-CoV-2
Ano de defesa: | 2023 |
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Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | , , , |
Tipo de documento: | Tese |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Federal de Santa Maria
Centro de Ciências da Saúde |
Programa de Pós-Graduação: |
Programa de Pós-Graduação em Ciências Farmacêuticas
|
Departamento: |
Análises Clínicas e Toxicológicas
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://repositorio.ufsm.br/handle/1/28499 |
Resumo: | In December 2019, cases of serious illness that caused an outbreak of pneumonia of unknown origin were reported in Wuhan, Hubei Province, China. Soon after, the number of cases skyrocketed dramatically, spreading across China and the world. The causative agent of the disease was called the new coronavirus, “SARS-CoV-2”. The clinical condition caused by the novel coronavirus has been referred to as COVID-19. Among the most common symptoms of COVID19 are fever, cough, fatigue and shortness of breath, while other symptoms include sputum production, headache, diarrhea, dyspnea and lymphopenia. Transmission occurs from person to person, mainly via direct contact or through droplets spread by coughing or sneezing from an infected individual, or through direct contact with infected people. Therefore, this study aimed to verify the clinical and oxidative status of patients with COVID-19 correlating with the severity of the disease, as well as characterizing changes in serum inflammatory mediators in hospitalized patients, correlating with death. The study involved 28 patients with mild COVID-19, who were in isolation at home; 65 patients admitted to the intensive care unit (ICU) of the HUSM, with moderate or severe COVID-19 and 50 participants in the control group. Clinical and social data were obtained through their electronic medical records. Oxidative stress markers were determined by quantifying oxidative damage markers such as thiobarbituric acid reactive substances (TBARS), as well as oxidative stress protectors (protein thiol groups (P-SH), vitamin C, ferric reduction ability of plasma (FRAP), Uric acid (UA), in addition to verifying the activity of enzyme δaminolevulinate dehydratase (δ-ALA-D). Inflammatory mediators were determined by measuring the levels of interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-4 (IL-4), interleukin-17 (IL-17), tumour necrosis factor alfa (TNF-α) and interferon-gamma (IFN-γ). Through the results obtained, we verified that patients with COVID-19 have an increase in oxidative damage markers (TBARS) and a decrease in antioxidant defenses (NP-SH, vitamin C, FRAP, UA), including the activity of the δ-ALA-D enzyme .In addition, the results of laboratory tests were evaluated, comparing the results of recovered patients with those who died. We found that geriatric patients, especially men, with comorbidities such as obesity and/or chronic diseases are more likely to develop the most severe form of COVID-19 than other patient groups. Patients with moderate/severe COVID-19 have higher oxidative stress and have lower δ-ALA-D enzyme activity compared to the control group.Levels of all inflammatory parameters were elevated in the moderate/severe COVID-19 serum compared to the control group. Laboratory parameters (urea, LDH, D-dimer,TAP/INR,AST, ALT) are increased in patients who died compared to recovered patients, with only the lymphocyte level being lower in patients who died compared to recovered patients. In conclusion, oxidative stress and interleukins can be used in clinical practice as a predictor of worsening of the clinical picture. |
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2023-03-31T11:33:45Z2023-03-31T11:33:45Z2023-02-28http://repositorio.ufsm.br/handle/1/28499In December 2019, cases of serious illness that caused an outbreak of pneumonia of unknown origin were reported in Wuhan, Hubei Province, China. Soon after, the number of cases skyrocketed dramatically, spreading across China and the world. The causative agent of the disease was called the new coronavirus, “SARS-CoV-2”. The clinical condition caused by the novel coronavirus has been referred to as COVID-19. Among the most common symptoms of COVID19 are fever, cough, fatigue and shortness of breath, while other symptoms include sputum production, headache, diarrhea, dyspnea and lymphopenia. Transmission occurs from person to person, mainly via direct contact or through droplets spread by coughing or sneezing from an infected individual, or through direct contact with infected people. Therefore, this study aimed to verify the clinical and oxidative status of patients with COVID-19 correlating with the severity of the disease, as well as characterizing changes in serum inflammatory mediators in hospitalized patients, correlating with death. The study involved 28 patients with mild COVID-19, who were in isolation at home; 65 patients admitted to the intensive care unit (ICU) of the HUSM, with moderate or severe COVID-19 and 50 participants in the control group. Clinical and social data were obtained through their electronic medical records. Oxidative stress markers were determined by quantifying oxidative damage markers such as thiobarbituric acid reactive substances (TBARS), as well as oxidative stress protectors (protein thiol groups (P-SH), vitamin C, ferric reduction ability of plasma (FRAP), Uric acid (UA), in addition to verifying the activity of enzyme δaminolevulinate dehydratase (δ-ALA-D). Inflammatory mediators were determined by measuring the levels of interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-4 (IL-4), interleukin-17 (IL-17), tumour necrosis factor alfa (TNF-α) and interferon-gamma (IFN-γ). Through the results obtained, we verified that patients with COVID-19 have an increase in oxidative damage markers (TBARS) and a decrease in antioxidant defenses (NP-SH, vitamin C, FRAP, UA), including the activity of the δ-ALA-D enzyme .In addition, the results of laboratory tests were evaluated, comparing the results of recovered patients with those who died. We found that geriatric patients, especially men, with comorbidities such as obesity and/or chronic diseases are more likely to develop the most severe form of COVID-19 than other patient groups. Patients with moderate/severe COVID-19 have higher oxidative stress and have lower δ-ALA-D enzyme activity compared to the control group.Levels of all inflammatory parameters were elevated in the moderate/severe COVID-19 serum compared to the control group. Laboratory parameters (urea, LDH, D-dimer,TAP/INR,AST, ALT) are increased in patients who died compared to recovered patients, with only the lymphocyte level being lower in patients who died compared to recovered patients. In conclusion, oxidative stress and interleukins can be used in clinical practice as a predictor of worsening of the clinical picture.Em dezembro de 2019, casos de doença grave que causaram um surto de pneumonia de origem desconhecida foram relatados em Wuhan, província de Hubei, China. Logo depois, o número de casos disparou dramaticamente, espalhando-se pela China e pelo mundo. O agente causador da doença, foi denominado SARS-CoV-2, o novo coronavírus. A condição clínica causada pelo novo coronavírus foi referida como COVID-19. Dentre os sintomas mais comuns da COVID-19 estão febre, tosse, fadiga e falta de ar, enquanto outros sintomas incluem produção de expectoração, dor de cabeça, diarréia, dispneia e linfopenia. A transmissão ocorre de pessoa para pessoa, principalmente via contato direto ou através de gotículas espalhadas por tosse ou espirros de um indivíduo infectado, ou através do contato direto com infectados. Diante disso, este trabalho objetivou verificar o perfil clínico e o estado oxidativo de pacientes com COVID-19 correlacionando com a gravidade da doença, assim como caracterizar as alterações nos mediadores inflamatórios séricos em pacientes hospitalizados correlacionando com óbito. O estudo contou com a participação de 28 pacientes com COVID-19 leve, que estavam em isolamento domiciliar; 65 pacientes internados na unidade de terapia intensiva (UTI) do HUSM, com COVID-19 moderado ou grave e 50 participantes no grupo controle. Os dados clínicos e sociais foram obtidos através do prontuário eletrônico dos mesmos. Os marcadores de estresse oxidativo foram determinados pela quantificação de marcadores de dano oxidativo como as substâncias reativas ao ácido tiobarbitúrico (TBARS), assim como protetores do estresse oxidativo (grupamentos tiólicos proteicos (P-SH), vitamina C,capacidade de redução férrica do plasma (FRAP), ácido úrico (UA), além da verificação da atividade da enzima δ-aminolevulinato desidratase (δ-ALA-D). Os mediadores inflamatórios foram determinados através da medição dos níveis de interleucina-2 (IL-2), interleucina-6 (IL-6), interleucina-10 (IL-10), interleucina- 4 IL-4), interleucina-17 (IL-17), fator de necrose tumoral alfa (TNF-α) e interferon-gama (IFN-γ). Além disso, foram avaliados os resultados de exames laboratoriais, comparando os resultados de pacientes recuperados com os que foram à óbito. Através dos resultados obtidos verificamos que pacientes com COVID-19 apresentam elevação nos marcadores de dano oxidativo (TBARS) e uma diminuição das defesas antioxidantes ( NP-SH, vitamina C, FRAP, UA), incluindo a atividade da enzima δ-ALA-D. Constatamos que pacientes geriátricos, especialmente homens, com comorbidades como obesidade e/ou doenças crônicas são mais propensos a desenvolver a forma mais grave de COVID-19 do que outros grupos de pacientes. Pacientes com COVID-19 moderado/grave apresentam maior estresse oxidativo e apresentaram menor atividade da enzima δ-ALA-D em comparação com o grupo controle. Os níveis de IL-2, IL6, IL-10 e IFN- γ estavam elevados no soro de COVID-19 moderado/severo em comparação com o grupo controle e os níveis de IL-6 e IL-10 apresentaram-se significativamente mais altos em individuos que foram à óbito. Os parâmetros laboratoriais (uréia, LDH, D-dimer,TAP/INR,AST, ALT) mostraram-se aumentados nos pacientes que faleceram em comparação aos pacientes recuperados, sendo apenas o nível de linfócitos inferior nos pacientes que foram a óbito em relação aos recuperados. Concluindos, o estresse oxidativo e as interleucinas podem ser utilizadas na prática clínica como preditor de piora do quadro clínico.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESporUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em Ciências FarmacêuticasUFSMBrasilAnálises Clínicas e ToxicológicasAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessSARS-CoV-2Covid-19Estresse oxidativoAntioxidantesδ-ALA-DImunidadeÓbitoOxidative stressAntioxidantsImmunityDeathCNPQ::CIENCIAS DA SAUDE::FARMACIAPerfil clínico, oxidativo e inflamatório em pacientes com SARS-CoV-2Clinical, oxidative and inflammatory profile in patients with SARS-CoV-2info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisBernasconi, Thissiane de Lima Gonçalveshttp://lattes.cnpq.br/1968750829053627Pillat, Micheli MainardiBenvegnú, Dalila MoterZanini, DanielaCarvalho, José Antonio Mainardi deHorner, Rosmarihttp://lattes.cnpq.br/6645332291724723Weber, Andressa de Azambuja Pias4003000000056001849872c-7fc6-4710-9b41-9e7cf329022d45985f5f-40f4-4bf1-8022-f901227979d67a275613-1979-4904-be3c-6c589ac2562be4ad247e-7807-4843-b499-f1b563e4d249ea57acdb-a2a0-46e3-b62f-d0c9ee429457068e0fba-8365-4f58-b92c-fe07c4f064d9990bfa75-c46f-4a01-b9e2-ec24b56bb572reponame:Biblioteca Digital de Teses e Dissertações do UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMLICENSElicense.txtlicense.txttext/plain; charset=utf-81956http://repositorio.ufsm.br/bitstream/1/28499/3/license.txt2f0571ecee68693bd5cd3f17c1e075dfMD53ORIGINALTES_PPGCF_2023_WEBER_ANDRESSA.pdfTES_PPGCF_2023_WEBER_ANDRESSA.pdfTese de Doutoradoapplication/pdf2106684http://repositorio.ufsm.br/bitstream/1/28499/1/TES_PPGCF_2023_WEBER_ANDRESSA.pdf1b64fd2478f6774399f648d4d07fec1fMD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805http://repositorio.ufsm.br/bitstream/1/28499/2/license_rdf4460e5956bc1d1639be9ae6146a50347MD521/284992023-03-31 08:33:46.084oai:repositorio.ufsm.br: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 Digital de Teses e Dissertaçõeshttps://repositorio.ufsm.br/ONGhttps://repositorio.ufsm.br/oai/requestatendimento.sib@ufsm.br||tedebc@gmail.comopendoar:2023-03-31T11:33:46Biblioteca Digital de Teses e Dissertações do UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.por.fl_str_mv |
Perfil clínico, oxidativo e inflamatório em pacientes com SARS-CoV-2 |
dc.title.alternative.eng.fl_str_mv |
Clinical, oxidative and inflammatory profile in patients with SARS-CoV-2 |
title |
Perfil clínico, oxidativo e inflamatório em pacientes com SARS-CoV-2 |
spellingShingle |
Perfil clínico, oxidativo e inflamatório em pacientes com SARS-CoV-2 Weber, Andressa de Azambuja Pias SARS-CoV-2 Covid-19 Estresse oxidativo Antioxidantes δ-ALA-D Imunidade Óbito Oxidative stress Antioxidants Immunity Death CNPQ::CIENCIAS DA SAUDE::FARMACIA |
title_short |
Perfil clínico, oxidativo e inflamatório em pacientes com SARS-CoV-2 |
title_full |
Perfil clínico, oxidativo e inflamatório em pacientes com SARS-CoV-2 |
title_fullStr |
Perfil clínico, oxidativo e inflamatório em pacientes com SARS-CoV-2 |
title_full_unstemmed |
Perfil clínico, oxidativo e inflamatório em pacientes com SARS-CoV-2 |
title_sort |
Perfil clínico, oxidativo e inflamatório em pacientes com SARS-CoV-2 |
author |
Weber, Andressa de Azambuja Pias |
author_facet |
Weber, Andressa de Azambuja Pias |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Bernasconi, Thissiane de Lima Gonçalves |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/1968750829053627 |
dc.contributor.advisor-co1.fl_str_mv |
Pillat, Micheli Mainardi |
dc.contributor.referee1.fl_str_mv |
Benvegnú, Dalila Moter |
dc.contributor.referee2.fl_str_mv |
Zanini, Daniela |
dc.contributor.referee3.fl_str_mv |
Carvalho, José Antonio Mainardi de |
dc.contributor.referee4.fl_str_mv |
Horner, Rosmari |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/6645332291724723 |
dc.contributor.author.fl_str_mv |
Weber, Andressa de Azambuja Pias |
contributor_str_mv |
Bernasconi, Thissiane de Lima Gonçalves Pillat, Micheli Mainardi Benvegnú, Dalila Moter Zanini, Daniela Carvalho, José Antonio Mainardi de Horner, Rosmari |
dc.subject.por.fl_str_mv |
SARS-CoV-2 Covid-19 Estresse oxidativo Antioxidantes δ-ALA-D Imunidade Óbito |
topic |
SARS-CoV-2 Covid-19 Estresse oxidativo Antioxidantes δ-ALA-D Imunidade Óbito Oxidative stress Antioxidants Immunity Death CNPQ::CIENCIAS DA SAUDE::FARMACIA |
dc.subject.eng.fl_str_mv |
Oxidative stress Antioxidants Immunity Death |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::FARMACIA |
description |
In December 2019, cases of serious illness that caused an outbreak of pneumonia of unknown origin were reported in Wuhan, Hubei Province, China. Soon after, the number of cases skyrocketed dramatically, spreading across China and the world. The causative agent of the disease was called the new coronavirus, “SARS-CoV-2”. The clinical condition caused by the novel coronavirus has been referred to as COVID-19. Among the most common symptoms of COVID19 are fever, cough, fatigue and shortness of breath, while other symptoms include sputum production, headache, diarrhea, dyspnea and lymphopenia. Transmission occurs from person to person, mainly via direct contact or through droplets spread by coughing or sneezing from an infected individual, or through direct contact with infected people. Therefore, this study aimed to verify the clinical and oxidative status of patients with COVID-19 correlating with the severity of the disease, as well as characterizing changes in serum inflammatory mediators in hospitalized patients, correlating with death. The study involved 28 patients with mild COVID-19, who were in isolation at home; 65 patients admitted to the intensive care unit (ICU) of the HUSM, with moderate or severe COVID-19 and 50 participants in the control group. Clinical and social data were obtained through their electronic medical records. Oxidative stress markers were determined by quantifying oxidative damage markers such as thiobarbituric acid reactive substances (TBARS), as well as oxidative stress protectors (protein thiol groups (P-SH), vitamin C, ferric reduction ability of plasma (FRAP), Uric acid (UA), in addition to verifying the activity of enzyme δaminolevulinate dehydratase (δ-ALA-D). Inflammatory mediators were determined by measuring the levels of interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-4 (IL-4), interleukin-17 (IL-17), tumour necrosis factor alfa (TNF-α) and interferon-gamma (IFN-γ). Through the results obtained, we verified that patients with COVID-19 have an increase in oxidative damage markers (TBARS) and a decrease in antioxidant defenses (NP-SH, vitamin C, FRAP, UA), including the activity of the δ-ALA-D enzyme .In addition, the results of laboratory tests were evaluated, comparing the results of recovered patients with those who died. We found that geriatric patients, especially men, with comorbidities such as obesity and/or chronic diseases are more likely to develop the most severe form of COVID-19 than other patient groups. Patients with moderate/severe COVID-19 have higher oxidative stress and have lower δ-ALA-D enzyme activity compared to the control group.Levels of all inflammatory parameters were elevated in the moderate/severe COVID-19 serum compared to the control group. Laboratory parameters (urea, LDH, D-dimer,TAP/INR,AST, ALT) are increased in patients who died compared to recovered patients, with only the lymphocyte level being lower in patients who died compared to recovered patients. In conclusion, oxidative stress and interleukins can be used in clinical practice as a predictor of worsening of the clinical picture. |
publishDate |
2023 |
dc.date.accessioned.fl_str_mv |
2023-03-31T11:33:45Z |
dc.date.available.fl_str_mv |
2023-03-31T11:33:45Z |
dc.date.issued.fl_str_mv |
2023-02-28 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://repositorio.ufsm.br/handle/1/28499 |
url |
http://repositorio.ufsm.br/handle/1/28499 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.cnpq.fl_str_mv |
400300000005 |
dc.relation.confidence.fl_str_mv |
600 |
dc.relation.authority.fl_str_mv |
1849872c-7fc6-4710-9b41-9e7cf329022d 45985f5f-40f4-4bf1-8022-f901227979d6 7a275613-1979-4904-be3c-6c589ac2562b e4ad247e-7807-4843-b499-f1b563e4d249 ea57acdb-a2a0-46e3-b62f-d0c9ee429457 068e0fba-8365-4f58-b92c-fe07c4f064d9 990bfa75-c46f-4a01-b9e2-ec24b56bb572 |
dc.rights.driver.fl_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Ciências Farmacêuticas |
dc.publisher.initials.fl_str_mv |
UFSM |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Análises Clínicas e Toxicológicas |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências da Saúde |
dc.source.none.fl_str_mv |
reponame:Biblioteca Digital de Teses e Dissertações do UFSM instname:Universidade Federal de Santa Maria (UFSM) instacron:UFSM |
instname_str |
Universidade Federal de Santa Maria (UFSM) |
instacron_str |
UFSM |
institution |
UFSM |
reponame_str |
Biblioteca Digital de Teses e Dissertações do UFSM |
collection |
Biblioteca Digital de Teses e Dissertações do UFSM |
bitstream.url.fl_str_mv |
http://repositorio.ufsm.br/bitstream/1/28499/3/license.txt http://repositorio.ufsm.br/bitstream/1/28499/1/TES_PPGCF_2023_WEBER_ANDRESSA.pdf http://repositorio.ufsm.br/bitstream/1/28499/2/license_rdf |
bitstream.checksum.fl_str_mv |
2f0571ecee68693bd5cd3f17c1e075df 1b64fd2478f6774399f648d4d07fec1f 4460e5956bc1d1639be9ae6146a50347 |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações do UFSM - Universidade Federal de Santa Maria (UFSM) |
repository.mail.fl_str_mv |
atendimento.sib@ufsm.br||tedebc@gmail.com |
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1801485600092585984 |