Metabolomic diferences between COVID-19 and H1N1 influenza induced ARDS

Autor: Jose Angel Lorente, Nicolas Nin, Palmira Villa, Dovami Vasco, Ana B. Miguel-Coello, Ignacio Rodriguez, Raquel Herrero, Oscar Peñuelas, Jesús Ruiz-Cabello, Jose L. Izquierdo-Garcia
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Critical Care, Vol 25, Iss 1, Pp 1-11 (2021)
Druh dokumentu: article
ISSN: 1364-8535
DOI: 10.1186/s13054-021-03810-3
Popis: Abstract Background Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by lung inflammation and pulmonary edema. Coronavirus disease 2019 (COVID-19) is associated with ARDS in the more severe cases. This study aimed to compare the specificity of the metabolic alterations induced by COVID-19 or Influenza A pneumonia (IAP) in ARDS. Methods Eighteen patients with ARDS due to COVID-19 and twenty patients with ARDS due to IAP, admitted to the intensive care unit. ARDS was defined as in the American-European Consensus Conference. As compared with patients with COVID-19, patients with IAP were younger and received more often noradrenaline to maintain a mean arterial pressure > 65 mm Hg. Serum samples were analyzed by Nuclear Magnetic Resonance Spectroscopy. Multivariate Statistical Analyses were used to identify metabolic differences between groups. Metabolic pathway analysis was performed to identify the most relevant pathways involved in ARDS development. Results ARDS due to COVID-19 or to IAP induces a different regulation of amino acids metabolism, lipid metabolism, glycolysis, and anaplerotic metabolism. COVID‐19 causes a significant energy supply deficit that induces supplementary energy-generating pathways. In contrast, IAP patients suffer more marked inflammatory and oxidative stress responses. The classificatory model discriminated against the cause of pneumonia with a success rate of 100%. Conclusions Our findings support the concept that ARDS is associated with a characteristic metabolomic profile that may discriminate patients with ARDS of different etiologies, being a potential biomarker for the diagnosis, prognosis, and management of this condition. Graphical Abstract
Databáze: Directory of Open Access Journals
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