DNA Damage in Moderate and Severe COVID-19 Cases: Relation to Demographic, Clinical, and Laboratory Parameters

Abstract

The ability of the SARS-CoV-2 virus to cause DNA damage in infected humans requires its study as a potential indicator of COVID-19 progression. DNA damage was studied in leukocytes of 65 COVID-19 patients stratified by sex, age, and disease severity in relation to demographic, clinical, and laboratory parameters. In a combined group of COVID-19 patients, DNA damage was shown to be elevated compared to controls (12.44% vs. 5.09%, p < 0.05). Severe cases showed higher DNA damage than moderate cases (14.66% vs. 10.65%, p < 0.05), and males displayed more damage than females (13.45% vs. 8.15%, p < 0.05). DNA damage is also correlated with international normalized ratio (INR) (r = 0.471, p < 0.001) and creatinine (r = 0.326, p < 0.05). In addition to DNA damage, severe COVID-19 is associated with age, C-reactive protein (CRP), and creatinine. Receiver operating characteristic analysis identified age, INR, creatinine, DNA damage, and CRP as significant predictors of disease severity, with cut-off values of 72.50 years, 1.46 s, 78.0 µmol/L, 9.72%, and 50.0 mg/L, respectively. The results show that DNA damage correlates with commonly accepted COVID-19 risk factors. These findings underscore the potential of DNA damage as a biomarker for COVID-19 severity, suggesting its inclusion in prognostic assessments to facilitate early intervention and improve patient outcomes.

Keywords: COVID-19; DNA damage; SARS-CoV-2 virus; comet assay.

Figure 1

% DNA in tail in leukocytes of healthy controls and COVID-19 patients. (a) % DNA in tail in leukocytes of control and COVID-19 patient groups. (b) % DNA in tail in leukocytes of male and female subgroups of healthy control and COVID-19 patients. Examples of DNA comets obtained by comet assay in peripheral blood leukocytes of (c) a healthy control subject and (d) a COVID-19 patient. The values are given as means ± SE = standard error. * p < 0.05—significant difference compared to control; ^a p < 0.05—significant difference compared to control in males; ^b p < 0.05—significant difference compared to control in females; ^# p < 0.05—significant difference compared to female patients.

Figure 2

% DNA in tail in leukocytes of male and female patients with moderate and severe COVID-19. (a) % DNA in tail in leukocytes of moderate and severe COVID-19 patient groups. (b) % DNA in tail in leukocytes of male and female subgroups of patients with moderate and severe COVID-19. The values are given as means ± SE. * p < 0.05—significant difference compared to moderate patients; ^a p < 0.05—significant difference compared to moderate female patients; ^b p < 0.05—significant difference between severe and moderate female patients.

Figure 3

% DNA in tail in leukocytes of adults (under 65 years) and elderly (65 years or older) patients with moderate and severe COVID-19. The values are given as means ± SE. ^a p < 0.05—significant difference compared to moderate patients under 65 years; ^b p < 0.05—significant difference compared to moderate patients over 65 years.

Figure 4

ROC curve analyses for distinguishing moderate from severe groups of COVID-19. ROC curves and AUC values for the (a) total group of patients, (b) male and (c) female patients, (d) under 65-year-old, and (e) over 65-year-old patients. Figures were obtained using SRplot [available at: http://www.bioinformatics.com.cn/srplot (accessed on 5 August 2024)].