Myeloperoxidase/paraoxonase ratio as a prognostic marker for post-COVID syndrome in patients undergoing hemodialysis: A cross-sectional cohort study

L.  Korol; N.  Stepanova; O.  Popova; N.  Malashevska; V.  Vasylchenko; T.  Ostapenko; A.  Rysyev; M.  Kolesnyk

doi:10.31450/ukrjnd.4(80).2023.09

L. Korol State Institution «Institute of Nephrology of the National Academy of Medical Sciences of Ukraine» https://orcid.org/0000-0002-5484-0326
N. Stepanova State Institution «Institute of Nephrology of the National Academy of Medical Sciences of Ukraine» https://orcid.org/0000-0002-1070-3602
O. Popova State Institution «Institute of Nephrology of the National Academy of Medical Sciences of Ukraine»
N. Malashevska State Institution «Institute of Nephrology of the National Academy of Medical Sciences of Ukraine»
V. Vasylchenko State Institution «Institute of Nephrology of the National Academy of Medical Sciences of Ukraine»
T. Ostapenko Dialysis Medical Center LLC “Nephrocenter”
A. Rysyev Dialysis Medical Center LLC “Link-Medital”
M. Kolesnyk State Institution «Institute of Nephrology of the National Academy of Medical Sciences of Ukraine» https://orcid.org/0000-0001-6658-3729

DOI: https://doi.org/10.31450/ukrjnd.4(80).2023.09

Keywords: hemodialysis, post-COVID syndrome, oxidative stress, antioxidant defense, myeloperoxidase, paraoxonase-1.

Abstract

The present study aimed to assess the impact of post-COVID syndrome on the oxidative status and activity of paraoxonase 1 (PON-1), myeloperoxidase (MPO), and leukocyte elastase in the blood of patients undergoing hemodialysis (HD).

Methods. In this cross-sectional cohort study, 290 patients undergoing HD were included. The oxidative status was assessed based on the levels of blood malondialdehyde (MDA), ceruloplasmin, thiol compounds (SH-groups), and the serum activities of myeloperoxidase (MPO), paraoxonase-1 (PON-1), and elastase were determined.

Results. It was found that HD patients exhibited an elevation in oxidative processes, characterized by increased blood concentrations of MDA, MPO, elastase activity, and a decrease in the levels of SH-groups and arylesterase activity of PON-1. Patients with post-COVID syndrome showed further increases in MPO activity and a decrease in arylesterase activity of PON-1. Additionally, a statistically significant elevation in the MPO/PON-1 ratio was observed in HD patients with post-COVID syndrome compared to the control group and patients examined before the onset of the pandemic (p < 0.0001). The MPO/PON-1 ratio exhibited a direct correlation with serum MDA levels (p < 0.0001) and inversely correlated with the concentration of ceruloplasmin (p = 0.0008). The MPO/PON-1 value surpassing 9.06 units was identified as a predictive marker for PCS, demonstrating a specificity of 68.4% and a sensitivity of 88.5%.

Conclusions. Our study highlights a significant impact of post-COVID syndrome on oxidative processes in HD patients, as evidenced by elevated MDA levels and MPO activity, along with reduced levels of antioxidants and arylesterase activity of PON-1. The MPO/PON-1 ratio emerges as a promising predictive marker for post-COVID syndrome, underlining its potential clinical relevance in identifying at-risk patients.

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