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The Role of the Oxidative Stress-Inflammation Axis in the COVID-19-Infected Patients with Chagas Disease: A Key Parameter To Be Considered During the Pandemic

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Duygu Aydemir at Koc University
Duygu Aydemir
Nuray N Ulusu at Koc University
Nuray N Ulusu
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Purpose of Review The global COVID-19 pandemic has become a major public health problem since December 2019, affecting millions of people, especially individuals with comorbidities including cancer, diabetes, hypertension, cardiovascular disease, obesity, and hematological disorders. People are still infected and die despite vaccination since the virus mutates quickly. Enzyme deficiencies, neglected conditions, and arboviral infections are currently discussed as potential contributors to COVID-19 vulnerability. Chagas disease (CD) is caused by the protozoan parasite Trypanosoma cruzi, affecting 6–8 million people worldwide, and CD is endemic in most of Latin America. Since people with CD have been found in the USA, Canada, Japan, and Europe because of the increased immigration, the spread and implications of CD have drawn attention since the disease shares similar pathogenesis with COVID-19. Recent Findings Enhanced oxidative stress and inflammation are the common features of CD and COVID-19 infection, leading to thrombosis, cardiomyopathy, thrombosis, cytokine storm, and heart failure associated with mortality and disease severity; therefore, it is still debated whether COVID-19 activates CD disease. On the other hand, CD patients can be more vulnerable to COVID-19 and show severe symptoms during the acute or chronic phase. Inflammation and oxidative stress are the first responses to COVID-19 or T. cruzi infections, where the vicious cycle between them is the key to infection pathogenesis. Therefore, this review discussed the importance of the oxidative stress-inflammation axis in disease pathogenesis, including thrombosis, immune response, cardiomyopathy, and heart failure. Additionally, antioxidant and anticoagulant therapies showed promising outcomes in the CD and COVID-19 patients addressing the importance of the oxidative stress-inflammation axis on the disease pathogenesis. Summary CD patients can be considered and treated as a risk group for COVID-19 infection even if the disease is in the silent phase to prevent mortality and severe symptoms. Antioxidant therapy should be considered a supportive treatment in CD patients infected with COVID-19.
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Vol:.(1234567890)
Current Clinical Microbiology Reports (2023) 10:108–119
https://doi.org/10.1007/s40588-023-00198-2
1 3
The Role oftheOxidative Stress‑Inflammation Axis
intheCOVID‑19‑Infected Patients withChagas Disease: AKey
Parameter To Be Considered During thePandemic
DuyguAydemir1,2 · NuriyeNurayUlusu1,2
Accepted: 8 June 2023 / Published online: 24 June 2023
© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023
Abstract
Purpose of Review The global COVID-19 pandemic has become a major public health problem since December 2019,
affecting millions of people, especially individuals with comorbidities including cancer, diabetes, hypertension, cardiovascular
disease, obesity, and hematological disorders. People are still infected and die despite vaccination since the virus mutates
quickly. Enzyme deficiencies, neglected conditions, and arboviral infections are currently discussed as potential contributors
to COVID-19 vulnerability. Chagas disease (CD) is caused by the protozoan parasite Trypanosoma cruzi, affecting 6–8
million people worldwide, and CD is endemic in most of Latin America. Since people with CD have been found in the USA,
Canada, Japan, and Europe because of the increased immigration, the spread and implications of CD have drawn attention
since the disease shares similar pathogenesis with COVID-19.
Recent Findings Enhanced oxidative stress and inflammation are the common features of CD and COVID-19 infection,
leading to thrombosis, cardiomyopathy, thrombosis, cytokine storm, and heart failure associated with mortality and disease
severity; therefore, it is still debated whether COVID-19 activates CD disease. On the other hand, CD patients can be
more vulnerable to COVID-19 and show severe symptoms during the acute or chronic phase. Inflammation and oxidative
stress are the first responses to COVID-19 or T. cruzi infections, where the vicious cycle between them is the key to
infection pathogenesis. Therefore, this review discussed the importance of the oxidative stress-inflammation axis in disease
pathogenesis, including thrombosis, immune response, cardiomyopathy, and heart failure. Additionally, antioxidant and
anticoagulant therapies showed promising outcomes in the CD and COVID-19 patients addressing the importance of the
oxidative stress-inflammation axis on the disease pathogenesis.
Summary CD patients can be considered and treated as a risk group for COVID-19 infection even if the disease is in the
silent phase to prevent mortality and severe symptoms. Antioxidant therapy should be considered a supportive treatment in
CD patients infected with COVID-19.
Keywords Chagas disease· COVID-19· Oxidative stress· İnflammation· Antioxidant defense
Introduction
COVID-19 pandemic resulted from SARS-CoV-2 virus
has become a major public health problem worldwide
since December 2019, and people are still infected and
die despite vaccination because of new virus variants [1].
Older individuals and people with comorbidities, including
cancer, diabetes, cardiovascular diseases, obesity, blood
disorders, and hypertension, are categorized as major risk
groups against COVID-19 infection [2]. However, other
health conditions, such as enzyme disorders, including
glucose 6-phosphate dehydrogenase (G6PD) deficiency,
neurodegenerative disorders, and neglected and arboviral
diseases, are currently discussed as potential contributors to
COVID-19 vulnerability [3, 4]. On the other hand, TMPRSS2
expression profile, blood group type, vitamin D status,
androgen/estrogen balance of individuals and mutations
in SARS-CoV2 virus such as S1/S2 cleavage site region,
* Duygu Aydemir
daydemir16@ku.edu.tr
1 School ofMedicine, Department ofMedical Biochemistry,
Koc University, Istanbul, Turkey
2 Koc University Research Center forTranslational Medicine
(KUTTAM), Istanbul, Turkey
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
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