1. The serum metabolome of COVID-19 patients is distinctive and predictive
- Author
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Jifang Sheng, Silan Gu, Wenrui Wu, Yingfeng Lu, Yanfei Chen, Lanjuan Li, Jiaojiao Xie, Ren Yan, Longxian Lv, Yi-Ling Du, Ding Shi, Huiyong Jiang, Kaijin Xu, Jiafeng Xia, Jing Guo, and Chenjie Huang
- Subjects
0301 basic medicine ,Male ,LC-MS, liquid chromatography-mass spectrometry ,Endocrinology, Diabetes and Metabolism ,CK-MB, creatine kinase-MB ,Hydroxybutyrates ,Butyric acid ,chemistry.chemical_compound ,AUC, area under the curve ,0302 clinical medicine ,Endocrinology ,GMP, guanosine monophosphate ,CRP, c-reactive protein ,GGT, gamma-glutamyl transpeptidase ,Prospective Studies ,Amino Acids ,Serum metabolome ,LPV/RTV, lopinavir/ritonavir ,HCs, healthy controls ,COVID-19, coronavirus disease 2019 ,LDH, lactate dehydrogenase ,TCA cycle, tricarboxylic acid cycle ,Area under the curve ,INR, international normalized ratio ,Middle Aged ,PCT, procalcitonin ,Lactic acid ,Cholesterol ,GM3s, monosialodihexosyl gangliosides ,Metabolome ,Female ,DB, direct bilirubin ,Citric acid ,Adult ,medicine.medical_specialty ,ALT, alanine transaminase ,Predictive value ,030209 endocrinology & metabolism ,Fructose ,SARS-CoV-2, severe acute respiratory syndrome coronavirus 2 ,Gas Chromatography-Mass Spectrometry ,Article ,WHO, World Health Organization ,03 medical and health sciences ,CHOL, total cholesterol ,Internal medicine ,PT, prothrombin time ,medicine ,Humans ,Lactic Acid ,ALB, albumin ,Aged ,PPARα, peroxisome proliferator-activated receptor alpha ,business.industry ,SARS-CoV-2 ,OPLS-DA, orthogonal partial least squares-discriminant analysis ,COVID-19 ,Glutamic acid ,COVID-19 Drug Treatment ,Oleic acid ,030104 developmental biology ,chemistry ,COPD, chronic obstructive pulmonary disease ,HBDH, hydroxybutyrate dehydrogenase ,Succinic acid ,GC–MS, gas chromatography–mass spectrometry ,business - Abstract
Background Metabolism is critical for sustaining life, immunity and infection, but its role in COVID-19 is not fully understood. Methods Seventy-nine COVID-19 patients, 78 healthy controls (HCs) and 30 COVID-19-like patients were recruited in a prospective cohort study. Samples were collected from COVID-19 patients with mild or severe symptoms on admission, patients who progressed from mild to severe symptoms, and patients who were followed from hospital admission to discharge. The metabolome was assayed using gas chromatography–mass spectrometry. Results Serum butyric acid, 2-hydroxybutyric acid, l -glutamic acid, l -phenylalanine, l -serine, l -lactic acid, and cholesterol were enriched in COVID-19 and COVID-19-like patients versus HCs. Notably, d -fructose and succinic acid were enriched, and citric acid and 2-palmitoyl-glycerol were depleted in COVID-19 patients compared to COVID-19-like patients and HCs, and these four metabolites were not differentially distributed in non-COVID-19 groups. COVID-19 patients had enriched 4-deoxythreonic acid and depleted 1,5-anhydroglucitol compared to HCs and enriched oxalic acid and depleted phosphoric acid compared to COVID-19-like patients. A combination of d -fructose, citric acid and 2-palmitoyl-glycerol distinguished COVID-19 patients from HCs and COVID-19-like patients, with an area under the curve (AUC) > 0.92 after validation. The combination of 2-hydroxy-3-methylbutyric acid, 3-hydroxybutyric acid, cholesterol, succinic acid, L-ornithine, oleic acid and palmitelaidic acid predicted patients who progressed from mild to severe COVID-19, with an AUC of 0.969. After discharge, nearly one-third of metabolites were recovered in COVID-19 patients. Conclusions The serum metabolome of COVID-19 patients is distinctive and has important value in investigating pathogenesis, determining a diagnosis, predicting severe cases, and improving treatment.
- Published
- 2021