DNA and RNA Oxidative Damage and Mortality of Patients With COVID-19

• Published in: The American journal of the medical sciences Vol. 361; no. 5; pp. 585 - 590
• Main Authors: Lorente, Leonardo, Martín, María M., González-Rivero, Agustín F., Pérez-Cejas, Antonia, Cáceres, Juan J., Perez, Alina, Ramos-Gómez, Luis, Solé-Violán, Jordi, Marcos y Ramos, José Alberto, Ojeda, Nazario, Jiménez, Alejandro
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2021; Southern Society for Clinical Investigation. Published by Elsevier Inc
• Subjects: Clinical Investigation; COVID-19; DNA and RNA oxidative damage; Mortality; Patients; Prognosis; COVID-19; DNA and RNA oxidative damage; Prognosis; Patients; Mortality
• ISSN: 0002-9629; 1538-2990
• DOI: 10.1016/j.amjms.2021.02.012

Deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) oxidative damage is associated with mortality of patients with different diseases. However, there are no data about DNA and RNA oxidative damage from coronavirus disease 2019 (COVID-19) patients. Thus, the objective of this study was to explore DNA and RNA oxidative damage in surviving and non-surviving COVID-19 patients.
Eight Intensive Care Units from 6 hospitals in the Canary Islands (Spain) participated in this prospective and observational study. We recorded the serum levels at ICU admission of the three guanine oxidized species (OGS) because guanine is the nucleobase that forms the DNA and RNA most prone to oxidation. Survival at 30 days was our end-point study.
Non-surviving (n = 11) compared to surviving patients (n = 42) had higher APACHE-II (p < 0.001), SOFA (p = 0.004) and serum OGS levels (p = 0.001). In logistic regression analyses an association between serum OGS levels and 30-day mortality after controlling for SOFA (OR=2.601; 95% CI=1.305–5.182; p = 0.007) or APACHE-II (OR=2.493; 95% CI=1.274–4.879; p = 0.008) was found. The area under curve (AUC) for mortality prediction by serum OGS levels was 83% (95% CI=70–92%; p < 0.001), by APACHE II was 85% (95% CI=75–96%; p < 0.001), and by SOFA was 80% (95% CI=66–94%; p < 0.001). No significant differences were found in the AUC between serum OGS levels and SOFA (p = 0.91), and serum OGS levels and APACHE-II (p = 0.64).
To our knowledge, this is the first study reporting on oxidative DNA and RNA damage in COVID-19 patients, and the main new finding was that serum OGS concentration was associated with mortality.