Leukocyte telomere dynamic change in patients with mild to moderate COVID-19 during three weeks of follow-up: relation with therapy

Running title: Leukocyte telomere length and COVID-19

  • Jelena Kotur-Stevuljević Faculty of Pharmacy Belgrade
  • Marina Roksandić Milenković Municipal Institute for Lung Diseases and Tuberculosis, Belgrade, Serbia
  • Jelena Vekić University of Belgrade, Faculty of Pharmacy, Department for Medical Biochemistry, Belgrade, Serbia
  • Nemanja Dimić University of Belgrade, Faculty of Medicine, University Clinical-Hospital Center Dr Dragisa Misovic-Dedinje, Belgrade
  • Dejan Dimić Municipal Institute for Lung Diseases and Tuberculosis, Belgrade, Serbia
  • Danica Ćujić University of Belgrade, Institute for the Application of Nuclear Energy INEP, Belgrade, Serbia
  • Azra Guzonjić University of Belgrade, Faculty of Pharmacy, Department for Medical Biochemistry, Belgrade, Serbia
  • Marija Gnjatović University of Belgrade, Institute for the Application of Nuclear Energy INEP, Belgrade, Serbia
  • Aleksandra Todorović University of Belgrade, Institute for the Application of Nuclear Energy INEP, Belgrade, Serbia
  • Nataša Bogavac-Stanojević University of Belgrade, Faculty of Pharmacy, Department for Medical Biochemistry, Belgrade, Serbia
DOI: https://doi.org/10.5937/jomb0-63678
Keywords: COVID-19; oxidative stress; telomere length; biomarker; vitamin D.

Abstract


Summary

 

Background: A three-year COVID-19 pandemic revealed a spectrum of disease severity and clinical manifestations. The most intriguing part of this phenomenon lays in inter-individual variability in COVID-19 course among patients, which is attributable to patient's age, comorbidities and general health status. Focus of this follow-up study was to assess leukocyte telomere length change in mild-to-moderate COVID-19 patients and concomitant influence of inflammation, oxidative stress (OS), pulmonary involvement and implemented therapy on the course of the disease.

Methods: Routine biochemical/haematological parameters, markers of OS (prooxidants and antioxidants), vitamin D, IgM and IgG antibodies level and relative length of leukocyte telomeres (rLTL) were measured at three time-points (at diagnosis, after 14 and 21 days from the disease onset) in blood samples of 31 consecutive COVID-19 patients, with a mild (n=16) and moderate (n=15) form of the disease, treated on an outpatient basis.

Results: Although the patients had reduced rLTL at baseline (median: 0.592; 25th – 75th percentiles: 0.518-0.724), it significantly increased during the follow-up (median: 0.773; 25th – 75th percentiles: 0.615-0.923; P<0.01). The rate of telomere attrition was associated with the extent of OS and pulmonary involvement. During follow-up, the burden of OS was reduced, while antioxidant defence mechanisms were recovered. The use of antibiotics and N-acetylcysteine-propolis supplementation was associated with telomere lengthening.

Conclusions: Results of this study revealed significant interaction between OS, inflammation and leukocyte telomere length attrition in COVID-19. Our data suggest that rRTL can be a biomarker that enables more precise therapy decision and accurate patient status estimation. 

 

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Published
2025/12/25
Issue
Ahead of print
Section
Original paper

Copyright (c) 2025 Jelena Kotur-Stevuljević, Marina Roksandić Milenković, Jelena Vekić, Nemanja Dimić, Dejan Dimić, Danica Ćujić, Azra Guzonjić, Marija Gnjatović, Aleksandra Todorović, Nataša Bogavac-Stanojević

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