# Oxidative stress in patients with coronavirus disease and end-stage renal disease: a pilot study

## TL;DR

This study explores oxidative stress in patients with both coronavirus disease and kidney failure, finding that combined conditions do not significantly increase oxidative stress.

## Contribution

The study is novel in comparing oxidative stress levels in patients with both COVID-19 and ESRD versus each condition alone.

## Key findings

- Oxidative stress was lower in patients with both COVID-19 and ESRD compared to those with only COVID-19.
- Antioxidant levels were higher in patients with both conditions compared to those with only ESRD or only COVID-19.
- Supplemental antioxidants may not provide therapeutic benefits for mild COVID-19 in ESRD patients.

## Abstract

Oxidative stress, an imbalance between reactive oxygen species production and antioxidant capacity, increases in patients with coronavirus disease (COVID-19) or renal impairment. We investigated whether combined COVID-19 and end-stage renal disease (ESRD) would increase oxidative stress levels compared to each disease alone.

Oxidative stress was compared among three groups. Two groups comprised patients with COVID-19 referred to the hospital with or without renal impairment (COVID-ESRD group [n = 18]; COVID group [n = 17]). The third group (ESRD group [n = 18]) comprised patients without COVID-19 on maintenance hemodialysis at a hospital.

The total oxidative stress in the COVID-ESRD group was lower than in the COVID group (p = 0.047). The total antioxidant status was higher in the COVID-ESRD group than in the ESRD (p < 0.001) and COVID (p < 0.001) groups after controlling for covariates. The oxidative stress index was lower in the COVID-ESRD group than in the ESRD (p = 0.001) and COVID (p < 0.001) groups. However, the three oxidative parameters did not differ significantly between the COVID and COVID-ESRD groups.

The role of reactive oxygen species in the pathophysiology of COVID-19 among patients withESRD appears to be non-critical. Therefore, the provision of supplemental antioxidants may not confer a therapeutic advantage, particularly in cases of mild COVID-19 in ESRD patients receiving hemodialysis. Nonetheless, this area merits further research.