Investigation of clinical effects of plasma coenzyme Q10 levels in COVİD-19 patients in intensive care

The COVID-19 pandemic continues its effects worldwide. In addition, the investigation of the clinical prognostic risk factors and the treatment options for the disease continue. Coenzyme Q10 is an important antioxidant that plays a role in membrane stability, energy conversion and ATP production. In the literature, studies showing the relationship of coenzyme Q10 level with disease course and survival in critical COVID-19 patients are very limited. In our study, it is aimed to examine the clinical effects of coenzyme Q10 level in COVID-19 patients in intensive care. After Ethics Committee Approval, COVID positive and suspected patients over 18 years of age who were admitted to the Hacettepe University Anesthesiology and Reanimation Intensive Care Unit between 1st January 2021 and 1st January 2022 were included in the study. Patients were divided into two groups as positive and negative. Criteria for the COVID-19 negative group; consecutive 4 negative PCR of the patient and the symptoms during hospitalization such as respiratory failure, general conditional disorder and gastrointestinal symptos could be explained by another clinical condition. Demographic data, comorbidities, admission symptoms, COVID-19 PCR results, APACHE-II and SOFA scores, length of stay, laboratory results, coenzyme Q10 levels, mechanical ventilation and vasopressor requirement and mortality of the patients were recorded prospectively. The relationship between coenzyme Q10 level with clinical findings, in-hospital morbidity and mortality was analyzed by statistical methods. Positive group has 96 and negative group has 62 patients. When factors related to coenzyme Q10 level at hospitalization were investigated, it was observed that the median coenzyme Q10 level was significantly higher in women than in men (1.28 and 1.18, p=0.035). Malignancy (p=0.008), neurological disease (p=0.038), and malnutrition (p=0.001) were associated with low coenzyme Q10 levels. No correlation was found between coenzyme Q10 level and vasopressor therapy, mechanical ventilation, RRT, and mortality. In addition, the presence of malnutrition was shown to increase the risk of mortality in the ICU 3-fold (HR: 3, 95% CI: 1.6- 5.4, p<0.001). In our study, no demographic and clinical factors related to coenzyme Q10 levels were found between the COVID positive and negative groups. It has been shown that plasma coenzyme Q10 level alone cannot be a factor predicting mortality and morbidity in this patient group. However, it should be kept in mind that low coenzyme Q10 level is an important component of malnutrition and malnutrition may be a significant risk factor for mortality.