Towards risk stratification and prediction of disease severity and mortality in COVID-19: Next generation metabolomics for the measurement of host response to COVID-19 infection

Autor: Robert A. Nagourney, Maria Auxiliadora Budib, Nakal Laurenço F. Silva, Ricardo Sobhie Diaz, Emilli Carvalho Arima, Fabricio Colacino Silva, Anton M. Palma, Marcia Batista Salzgeber, Rafaela Moraes Siufi Silva, Wellington Galhano Martins, Robson Mateus Appel, Ricardo Ayache, Saturnino Sarat Júnior, Paulo D'Amora, Ismael Dale C. G. Silva, Ana Carolina Alvarenga, Steven S. Evans, Henrique Budib Dorsa Pontes
Rok vydání: 2021
Předmět:
Male
Ornithine
RNA viruses
Viral Diseases
Pulmonology
Physiology
Epidemiology
Metabolite
Disease
Pathology and Laboratory Medicine
Severity of Illness Index
Biochemistry
Gastroenterology
chemistry.chemical_compound
Medical Conditions
Immunodeficiency Viruses
Risk Factors
Medicine and Health Sciences
Metabolites
Citrulline
Medicine
Kynurenine
Multidisciplinary
Tryptophan
Middle Aged
Body Fluids
Infectious Diseases
Blood
Medical Microbiology
Area Under Curve
Viral Pathogens
Urea cycle
Viruses
Metabolome
Female
Anatomy
Pathogens
Research Article
Adult
medicine.medical_specialty
Science
Glutamic Acid
Microbiology
Blood Plasma
Carnitine
Internal medicine
Retroviruses
Humans
Metabolomics
Microbial Pathogens
Aged
Glutaminolysis
Receiver operating characteristic
SARS-CoV-2
business.industry
Lentivirus
Organisms
COVID-19
Biology and Life Sciences
HIV
Covid 19
Pneumonia
Health Care
Metabolism
ROC Curve
chemistry
Medical Risk Factors
Health Statistics
Morbidity
business
Zdroj: PLoS ONE
PLoS ONE, Vol 16, Iss 12, p e0259909 (2021)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0259909
Popis: This study investigated the association between COVID-19 infection and host metabolic signatures as prognostic markers for disease severity and mortality. We enrolled 82 patients with RT-PCR confirmed COVID-19 infection who were classified as mild, moderate, or severe/critical based upon their WHO clinical severity score and compared their results with 31 healthy volunteers. Data on demographics, comorbidities and clinical/laboratory characteristics were obtained from medical records. Peripheral blood samples were collected at the time of clinical evaluation or admission and tested by quantitative mass spectrometry to characterize metabolic profiles using selected metabolites. The findings in COVID-19 (+) patients reveal changes in the concentrations of glutamate, valeryl-carnitine, and the ratios of Kynurenine/Tryptophan (Kyn/Trp) to Citrulline/Ornithine (Cit/Orn). The observed changes may serve as predictors of disease severity with a (Kyn/Trp)/(Cit/Orn) Receiver Operator Curve (ROC) AUC = 0.95. Additional metabolite measures further characterized those likely to develop severe complications of their disease, suggesting that underlying immune signatures (Kyn/Trp), glutaminolysis (Glutamate), urea cycle abnormalities (Cit/Orn) and alterations in organic acid metabolism (C5) can be applied to identify individuals at the highest risk of morbidity and mortality from COVID-19 infection. We conclude that host metabolic factors, measured by plasma based biochemical signatures, could prove to be important determinants of Covid-19 severity with implications for prognosis, risk stratification and clinical management.
Databáze: OpenAIRE
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