Correlations between soluble receptor for advanced glycation end products and heme oxogenase-1 in post-COVID-19 patients with telogen effluvium

Background Telogen effluvium (TE), a form of nonscarring alopecia, has emerged as a common postinfection sequela of coronavirus disease 2019 (COVID-19). Increasing evidence suggests that oxidative stress and impaired antioxidant defense may play key roles in its pathogenesis. Objective To evaluate serum levels of soluble receptor for advanced glycation end products (sRAGE) and heme oxygenase-1 (HO-1) as markers of oxidative and antioxidative status, respectively, in post-COVID-19 patients with TE and to explore their association with TE severity and hair clinical characteristics. Patients and methods This comparative cross-sectional study included 90 participants divided equally into three groups: post-COVID-19 patients with TE (group A), post-COVID-19 patients without hair loss (group B), and healthy controls (group C). All underwent clinical and trichoscopic evaluation. Serum sRAGE and HO-1 levels were measured using ELISA. Results Group A exhibited significantly higher sRAGE levels (655.9±449.2 ng/l) than group B (347.0±41.8 ng/l) and group C (55.6±32.6 ng/l; P<0.001). Conversely, HO-1 was lowest in group A (0.58±0.54 ng/l) compared with group B (1.37±1.51 ng/l) and group C (6.47±3.36 ng/l; P<0.001). sRAGE levels correlated positively with TE severity (P<0.001), while HO-1 levels showed a negative correlation. Both markers were independent predictors of TE in multivariate analysis. Conclusion An imbalance between oxidative stress and antioxidant defense, reflected by elevated sRAGE and reduced HO-1, is strongly associated with post-COVID-19 TE. These biomarkers may aid in early diagnosis and monitoring of post-COVID-19 TE.