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Chavarría AP, Vázquez RRV, Cherit JGD, Bello HH, Suastegui HC, Moreno-Castañeda L, Alanís Estrada G, Hernández F, González-Marcos O, Saucedo-Orozco H, Manzano-Pech L, Márquez-Velasco R, Guarner-Lans V, Pérez-Torres I, Soto ME. Antioxidants and pentoxifylline as coadjuvant measures to standard therapy to improve prognosis of patients with pneumonia by COVID-19. Comput Struct Biotechnol J 2021; 19:1379-1390. [PMID: 33680348 PMCID: PMC7910139 DOI: 10.1016/j.csbj.2021.02.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/01/2021] [Accepted: 02/16/2021] [Indexed: 01/08/2023] Open
Abstract
The type 2 coronavirus causes severe acute respiratory syndrome (SARS-CoV-2) and produces pneumonia with pulmonary alveolar collapse. In some cases it also causes sepsis and septic shock. There is no specific treatment for coronavirus disease 2019 (COVID-19). Vitamin C (Vit C), Vitamin E (Vit E), N-acetylcysteine (NAC) and Melatonin (MT) increase the intracellular content of GSH, kidnap free radicals and protect DNA, proteins in the cytosol and lipids in cell membranes. Pentoxifylline (Px) has anti-inflammatory activities. Here we evaluate the effect of Vit C, Vit E, NAC, and MT plus Px in COVID-19 patients with moderate and severe pneumonia. 110 patients of either sex were included. They were divided into five groups with 22 patients each. Group 1 received Vit C + Px, group 2 Vit E + Px, group 3 NAC + Px, group 4 MT + Px, and group 5 only Px. Oxidative stress (OS) markers such as lipid peroxidation (LPO) levels, total antioxidant capacity (TAC) and nitrites (NO2 -) were evaluated in plasma. The antioxidant therapy improved the survival scores including the Sequential Organ Failure Assessment (SOFA), the Acute Physiology and chronic Health Evaluation II (Apache II), the Simplified Acute Physiology Score II (SAPS II), the Critical Illness Risk Score, Launched during COVID-19 crisis (COVIDGRAM) and the Glasgow Coma Scale (GCS). We found that LPO (p≤0.04) and inflammation markers such as interleukin-6 (IL-6, p≤ 0.01), C reactive protein (CRP, p ≤ 0.01) and procalcitonin (PCT, p ≤ 0.05) were elevated. TAC (p ≤ 0.03) and NO2 - (p ≤ 0.04) found themselves diminished in diminished in COVID-19 patients upon admission to the hospital. The different antioxidants reversed this alteration at the end of the treatment. The treatment with antioxidant supplements such as Vit C, E, NAC, and MT plus Px could decelerate the aggressive and lethal development of COVID-19. Antioxidant therapy can be effective in this pandemia since it improves the survival scores including SOFA, Apache II, SAPS II, COVIDGRAM, GCS by lowering the LPO, IL-6, CRP, PCT and increasing systemic TAC and NO2 -.
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Affiliation(s)
- Adrián Palacios Chavarría
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center Av. del Conscripto 311, Lomas de Sotelo, Hipódromo de las Américas, Miguel Hidalgo, 11200 Ciudad de México, CDMX, Mexico
- Critical Care in American British Cowdray (ABC) Medical Center, I.A.P. ABC I.A.P. ABC Sur 136 No. 116 Col. Las Américas, México City 01120 , Mexico
| | - Rafael Ricardo Valdez Vázquez
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center Av. del Conscripto 311, Lomas de Sotelo, Hipódromo de las Américas, Miguel Hidalgo, 11200 Ciudad de México, CDMX, Mexico
| | - José Guillermo Domínguez Cherit
- Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” Vasco de Quiroga 15, Sección XVI, Tlalpan, México City 14000, Mexico
- Tecnológico de Monterrey EMCS, Mexico
| | - Héctor Herrera Bello
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center Av. del Conscripto 311, Lomas de Sotelo, Hipódromo de las Américas, Miguel Hidalgo, 11200 Ciudad de México, CDMX, Mexico
| | - Humberto Castillejos Suastegui
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center Av. del Conscripto 311, Lomas de Sotelo, Hipódromo de las Américas, Miguel Hidalgo, 11200 Ciudad de México, CDMX, Mexico
| | - Lidia Moreno-Castañeda
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center Av. del Conscripto 311, Lomas de Sotelo, Hipódromo de las Américas, Miguel Hidalgo, 11200 Ciudad de México, CDMX, Mexico
| | - Gabriela Alanís Estrada
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center Av. del Conscripto 311, Lomas de Sotelo, Hipódromo de las Américas, Miguel Hidalgo, 11200 Ciudad de México, CDMX, Mexico
| | - Fabián Hernández
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center Av. del Conscripto 311, Lomas de Sotelo, Hipódromo de las Américas, Miguel Hidalgo, 11200 Ciudad de México, CDMX, Mexico
| | - Omar González-Marcos
- Critical Care Unit of the Temporal COVID-19 Unit, Citibanamex Center Av. del Conscripto 311, Lomas de Sotelo, Hipódromo de las Américas, Miguel Hidalgo, 11200 Ciudad de México, CDMX, Mexico
| | - Huitzilihuitl Saucedo-Orozco
- Cardioneumology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico
- Cardioneumology Department, Centro Médico Nacional La Raza Instituto Mexicano del Seguro Social Seris y Zaachila, Col. La Raza Azcapotzalco, 02990 Ciudad de México, CDMX, Mexico
| | - Linaloe Manzano-Pech
- Department of Cardiovascular Biomedicine, Instituto Nacional de Cardiología Ignacio Chávez. Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico
| | - Ricardo Márquez-Velasco
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez. Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico
| | - Verónica Guarner-Lans
- Department of Physiology, Instituto Nacional de Cardiología Ignacio Chávez. Badiano 1, Sección XVI, Tlalpan, México City 14080 Mexico
| | - Israel Pérez-Torres
- Department of Cardiovascular Biomedicine, Instituto Nacional de Cardiología Ignacio Chávez. Badiano 1, Sección XVI, Tlalpan, México City 14080, Mexico
| | - Maria Elena Soto
- Department of Immunology , Instituto Nacional de Cardiología Ignacio Chávez. Juan Badiano 1 , Sección XVI , Tlalpan , México City 14080 , Mexico
- American British Cowdray (ABC) Medical Center , I.A.P. ABC I.A.P. ABC Sur 136 No. 116 Col. Las Américas , México City 01120 , Mexico
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