Martinez-Mesa, AlvaroCabrera-Cesar, EvaMartin-Montañez, ElisaSanchez-Alvarez, EstherLopez, Pilar MartinezRomero-Zerbo, YaninaGarcia-Fernandez, MariaVelasco-Garrido, Jose Luis2023-02-092023-02-092021-07-27Martinez Mesa A, Cabrera César E, Martín-Montañez E, Sanchez Alvarez E, Lopez PM, Romero-Zerbo Y, et al. Acute lung injury biomarkers in the prediction of COVID-19 severity: total thiol, ferritin and lactate dehydrogenase. Antioxidants (Basel). 2021 Jul 29;10(8):12212076-3921http://hdl.handle.net/10668/18419SARS-CoV-2 (COVID-19) patients who develop acute respiratory distress syndrome (ARDS) can suffer acute lung injury, or even death. Early identification of severe disease is essential in order to control COVID-19 and improve prognosis. Oxidative stress (OS) appears to play an important role in COVID-19 pathogenesis; we therefore conceived a study of the potential discriminative ability of serum biomarkers in patients with ARDS and those with mild to moderate disease (non-ARDS). 60 subjects were enrolled in a single-centre, prospective cohort study of consecutively admitted patients: 29 ARDS/31 non-ARDS. Blood samples were drawn and marker levels analysed by spectrophotometry and immunoassay techniques. C-reactive protein (CRP), lactate dehydrogenase (LDH), and ferritin were significantly higher in ARDS versus non-ARDS cases at hospital admission. Leukocytes, LDH, ferritin, interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-α) were also significantly elevated in ARDS compared to non-ARDS patients during the hospital stay. Total thiol (TT) was found to be significantly lower in ARDS. Conversely, D-dimer, matrix metalloproteinase-9 (MMP-9) and advanced glycosylated end products (AGE) were elevated. Leukocytes, LDH, CRP, ferritin and IL-6 were found to be significantly higher in non-survivors. However, lymphocyte, tumour necrosis factor beta (TGF-β), and TT were lower. In summary, our results support the potential value of TT, ferritin and LDH as prognostic biomarkers for ARDS development in COVID-19 patients, distinguishing non-ARDS from ARDS (AUCs = 0.92; 0.91; 0.89) in a fast and cost-effective manner. These oxidative/inflammatory parameters appear to play an important role in COVID-19 monitoring and can be used in the clinical management of patients.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/COVID-19LDHacute respiratory distress syndromebiomarkersferritinprognosistotal thiolRespiratory Distress SyndromeRespiratory Distress Syndrome, NewbornBiomarkersPrognosisresearch article34439469open accessBiomarkersFerritinsPrognosisRespiratory Distress SyndromeSulfhydryl Compounds10.3390/antiox10081221PMC8388961https://www.mdpi.com/2076-3921/10/8/1221/pdf?version=1629697709https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8388961/pdf