Respiratory Burst Factors in Nigerian Patients with COVID-19

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Ganiyu Arinola
Fabian Edem
Temitope Alonge


Respiratory burst function resulting in the release of reactive oxygen species from leucocytes is one of the key mechanisms of innate immune system to prevent the establishment of intracellular pathogens in the host cells. Previous studies on COVID-19 patients concentrated on adaptive immunity while study on respiratory burst functions is lacking. Respiratory burst mediators levels [nitric oxide (NO) and hydrogen peroxide (H2O2)] and respiratory burst enzymes activities [Catalase (CAT), Myeloperoxidase (MPO) and Superoxide dismutase (SOD)] were quantitated in the plasma Mean plasma NO level, MPO activity and H2O2 level were significantly decreased while SOD activity was significantly increased in COVID-19 patients at admission compared with control. Mean plasma NO level significantly decreased while MPO activity was significantly increased in COVID-19 patients at discharge compared with control. Plasma NO level, H2O2 level and MPO activity were significantly increased in COVID-19 patients at discharge compared with COVID-19 patients at admission. In COVID-19 patients that spent ?10days in admission, the levels of NO and H2O2 were significantly increased compared with the levels of NO and H2O2 in COVID-19 patients that spent <10days in admission. In male COVID-19 patients, NO level and MPO activity were significantly increased compared with MPO activity in female patients. In COVID-19 patients ?40years of age, NO level was significantly decreased while MPO activity was significantly increased compared with COVID-19 patients <40yrs of age. In male COVID-19 patients, NO level and MPO activity was significantly increased compared with MPO activity in female patients. It could be concluded from this study that factors of respiratory burst which are components of the innate immune system are altered in COVID-19 patients and could be involved in the immune-pathogenecity of SARS-CoV-2; and that MPO coupled with NO may explain differential severities of COVID-19 among genders and age groups.


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Addo, M.M.; Alfred, M. (2014). Sex-based differences in HIV-type 1 pathogenesis. J. Infect. Dis. 209, S86–S92.

Akerström S, Mousavi-Jazi M, Klingström J, Leijon M, Lundkvist A, Mirazimi A. (2005). Nitric oxide inhibits the replication cycle of severe acute respiratory syndrome coronavirus. J Virol. 79: 1966–1969.

Alvarez RA, Berra L, Gladwin MT. 2020. Home Nitric Oxide Therapy for COVID-19. American Journal of Respiratory and Critical Care Medicine. (202) 1: 16-20

Aratani Y, Miura N, Ohno N, Suzuki K.(2012). Role of neutrophil-derived reactive oxygen species in host defense and inflammation. Med Mycol J. 53(2):123-8. doi: 10.3314/mmj.53.123.

Arinola OG. (2003). Cells of the Immune System, Chapter 6 in Basic Immunology for Students of Medicine and Biology. ISBN: 9782194328 Edited by L.S. Salimonu, College Press, Nigeria. pp: 48-55.

Arinola O.G, Onifade A.A, Edem F.V and Yaqub S.A (2021a). Detection of anti SARS-COV 2 specific -IgG and -IgM antibodies in COVID-19 patients using rapid screening immunochromatographic cassettes. Annals of Epidemiology and Public Health.4(1): 1059.

Arinola O.G, Edem V.F, Rahamon S.K, Yaqub S.A, Fashina A.O and Alonge T.O. (2020). SARS-CoV-2 Infection Screening Using Two Serological Testing Methods. NigerianJ. Physiol. Sci. 35: 117 – 121.

Arinola, G.O, O.A. Fashina, O.C. Oluyomi Ishola, O.I. Akinbola, S.A. Akinbile, A.O. Eegunjobi, M.D. Bello, F.V. Edem, S.K. Rahamon, O.I. Famuyiwa, A.J. Olaoti, O.A.Olaniyan, A.C. Oke, A. Fowotade, O. Abimbola, J.O. Johnson, O.S. Fagbemi, Funmi Salami, T.O. Alonge(2021b). Demographic attributes of COVID-19 patients in an infectious disease center of Nigeria. Afr. Journal of Clinical and Experimental Microbiology. 22(1): 21-27.

Blanco-Me lo, D., Nilsson-Payant , B.E., Liu, W.C., Uhl, S., Hoagland, D., Møller, R., Jordan, T.X., Ois hi, K., Pan is, M., Sachs, D., et al. (2020). Imbalanced host response to SARS -CoV-2 drives development of COVID-19. Cell. S0092-8674(20)30489- X.

Buckley C. D., Gilroy D. W. & Serhan C. N. (2014). Proresolving lipid mediators and mechanisms in the resolution of acute inflammation. Immunity.40: 315–327.

Burak O and Ahmet Y. (2020). Could the decrease in the endothelial nitric oxide (NO) production and NO bioavailability be the crucial cause of COVID-19 related deaths? Med. Hypotheses. 144:109970. doi: 10.1016/j.mehy.2020.109970.

Chen L, Liu P, Gao H, Sun B, Chao D, Wang F, et al. (2004). Inhalation of nitric oxide in the treatment of severe acute respiratory syndrome: a rescue trial in Beijing. Clin Infect Dis. 39: 1531–1535.

Davies KJA. (2016). The Oxygen Paradox, Oxidative Stress, and Ageing. Arch Biochem Biophys. 595: 28-32.

Delgado-Rochea L and Mestaba F. (2020). Oxidative Stress as Key Player in Severe Acute Respiratory SyndromeCoronavirus (SARS-CoV) Infection. ARCME 51(5): 384–387

Diodata, M.D.; Knoferl, M.W.; Schwacha, M.G.; Bland, K.I.; Chaudry, I.H. (2001). Gender differences in theinflammatory response and survival following haemorrhage and subsequent sepsis. Cytokine. 14,162–169.

Edem V.F and Arinola O.G. (2015). Leucocyte migration and intracellular killing in newly diagnosed pulmonary tuberculosis patients and during anti-tuberculosis chemotherapy. Annals of Global Health. 81(5): 669-674.

Emokpae MA and Aghogho B (2016). Do Sex Differences in Respiratory Burst EnzymeActivities Exist in Human ImmunodeficiencyVirus-1 Infection? Medical Sciences, 4, 19. doi:10.3390/medsci4040019

Epidemiology Working Group for NCIP Epidemic Response. (2020). The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Chin. J. Epidemiol.41: 145–151.

Fung TS, Liu DX. (2019). Human Coronavirus: Host-Pathogen Interaction. Annu Rev Microbiol. 73:529e557.

Galbán C, Montejo JC, Mesejo A, Marco P, Celaya S, Sánchez-Segura JM, Farré M, Bryg DJ. (2000). An immune-enhancing enteral diet reduces mortality rate and episodes of bacteremia in septic intensive care unit patients. Crit Care Med. 28:643–648. doi: 10.1097/00003246-200003000-00007.

Gil del Valle L, Gravier Hernandez R, Delgado Roche L, et al. (2015). Oxidative Stress in the Aging Process: Fundamental Aspects and New In-sights. In: ACS Symposium Series, pp. 177e219.

Griffiths MJ, Evans TW. Inhaled nitric oxide therapy in adults. (2005). N Engl J Med. 353: 2683–2695.

Ignarro LJ. (2020). Inhaled NO and COVID-19. Brit. J. Pharmacology. 177(16): 3848-3849.

Jilma B, Kastner J, Mensik C, Vondrovec B, Hildebrandt J, Krejcy K, Wagner OF, Eichler HG. (1996). Sex differences in concentrations of exhaled nitric oxide and plasma nitrate. Life Sci. 58(6): 469-76. doi: 10.1016/0024-3205(95)02311-9.

Kauser K, Rubanyi GM. (1995). Gender difference in endothelial dysfunction in the aorta of spontaneously hypertensive rats. Hypertension. 25: 517–523.

Li G, Fan Y, Lai Y. Han T, Li Z, Pan P, Wang W et al. (2020). Coronavirus infections and immune responses. J. Med. Vir.

Liao, M. et al. (2020). The landscape of lung bronchoalveolar immune cells in COVID-19 revealed by single-cell RNA sequencing. Preprint at medRxiv

Lahera V, Salom MG, Miranda-Guardiola F et al. (1991). Effects of N-nitro-L-arginine methyl ester on renal function and blood pressure. Am. J. Physiol. 1991; 261:F1033–F1037.

Lipsitch M, Swerdlow DL, Finelli L. (2020). Defining the Epidemiology of Covid-19 - Studies Needed. N Engl J Med. 382:1194e1196.

Logsdon, C.D.; Li, B. (2013). The role of protein synthesis and digestive enzymes in acinar cell injury.Nat. Rev.Gastroenterol. Hepatol. 10, 362–370.

McKechnie J.L and Blish C.A. (2020). The Innate Immune System: Fighting on the Front Lines or Fanning the Flames of COVID-19? Cell Host and Microbes.27 (6): 863-869

Morris SM., Jr. (2010). Arginine: Master and commander in innate immune responses. Sci Signal. 3:pe27. doi: 10.1126/scisignal.3135pe27.

Ochoa JB, Strange J, Kearney P, Gellin G, Endean E, Fitzpatrick E. (2001). Effects of L-arginine on the proliferation of T lymphocyte subpopulations. J Parenter Enteral Nutr. 25:23–29. doi: 10.1177/014860710102500123.

Olaniyi JA and Arinola OG. (2011). Humoral immunoglobulin factors and nitric oxide levels in HIV patients with low CD4+ T-lymphocyte count. Intl. J of Health Research. 4(2). 67-74.

Oxley TJ, Mocco J, Majidi S, Kellner CP, Shoirah H, Singh IP, et al. (2020). Large-vessel stroke as a presenting feature of Covid-19 in the young. N Engl J Med. 382: e60.

Peterhans E. (1997). Oxidants and Antioxidants in Viral Diseases: Disease Mechanisms and Metabolic Regulation. The Journal of Nutrition. 127(5): 962S–965S.

Qin, M. et al. (2020). An Antioxidant Enzyme Therapeutic for COVID-19. bioRxiv preprint. doi:

Rodriguez PC, Quiceno DG, Ochoa AC. (2007).L-arginine availability regulates T-lymphocyte cell-cycle progression. Blood. 109:1568–1573. doi: 10.1182/blood-2006-06-031856.

Ruan, Q., Yang, K., Wang, W., Jiang, L. & Song, J. (2020). Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med 46(5), 846-848 .

Ricciardolo FLM, Di Stefano A, Sabatini F, Folkerts G. (2006). Reactive nitrogen species in the respiratory tract (Review). European Journal of Pharmacology. 533 (1–3). 8: 240-252.

Stancioiu F, Papadakis GZ, Kteniadakis S, Izotov BN, Coleman MD, Spandidos DA and Tsatsakis A. (2020). A dissection of SARS-CoV2 with clinical implications (Review). Int. J. Mol. Med. 46(2): 489–508. doi: 10.3892/ijmm.2020.4636.

Schroder, M.; Kaufman, R.J. (2005). The mammalian unfold protein response. Annu. Rev. Biochem. 74, 739–789.

Taneja, V. (2018). Sex hormones determine immune response. Front. Immunol.9: 1931-1938

Tian, S. Hu, W., Niu, L., Liu, H., Xu, H., & Xiao, S. Y. (2020). Pulmonary pathology of early phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. J. Thorac. Oncol. 15(5): 700–704

van der Veen BS, de Winther MP, Heeringa P.(2009).Myeloperoxidase: molecular mechanisms of action and their relevance to human health and disease. Antioxid Redox Signal. 11(11):2899-937. doi: 10.1089/ars.2009.2538.

Weiner CP, Lizasain I, Baylis SA et al. (1994). Induction of calcium dependent NO synthase by sex hormones. Proc Natl Acad Sci USA. 91:5212–5216

WHO Director-General's opening remarks at the media briefing on COVID-19 – 11 March 2020. World Health Organization.

Xu, H. et al.(2020). High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int. J. Oral. Sci.12: 8-16.

Xu, Z. et al. (2020).Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir. Med.8: 420–422.

Ye Z, Zhang Y, Wang Y, Huang Z, Song B. (2020). Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. DOI: 10.1007/s00330-020-06801-0.

Yoo SK, Huttenlocher A.(2009). Innate immunity: wounds burst H2O2 signals to leukocytes. Curr Biol. 28:19(14): R553-555. doi: 10.1016/j.cub.2009.06.025.

Zhou, F. et al. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet.395: 1054–1062.

Zhou, Y. et al. (2020). Pathogenic T cells and inflammatory monocytes incite inflammatory storm in severe COVID-19 patients. Natl Sci. Rev. nwaa041

Zhou, Z ., Ren, L., Zhang , L ., Zhong, J., Xiao, Y ., Jia, Z., Guo, L., Yang, J. ,Wang, C ., Jiang, S., et al. (2020). Heightened innate immune responses in the respiratory tract of COVID-19 patients. Cell Host Microbe. (20). S1931-3128.