Diagnostic, Prognostic and Mechanistic Biomarkers of COVID-19 Identified by Mass Spectrometric Metabolomics

A number of studies have assessed the impact of SARS-CoV-2 infection and COVID-19 severity on the metabolome of exhaled air, saliva, plasma, and urine to identify diagnostic and prognostic biomarkers. In spite of the richness of the literature, there is no consensus about the utility of metabolomic analyses for the management of COVID-19, calling for a critical assessment of the literature. We identified mass spectrometric metabolomic studies on specimens from SARS-CoV2-infected patients and subjected them to a cross-study comparison. We compared the clinical design, technical aspects, and statistical analyses of published studies with the purpose to identify the most relevant biomarkers. Several among the metabolites that are under- or overrepresented in the plasma from patients with COVID-19 may directly contribute to excessive inflammatory reactions and deficient immune control of SARS-CoV2, hence unraveling important mechanistic connections between whole-body metabolism and the course of the disease. Altogether, it appears that mass spectrometric approaches have a high potential for biomarker discovery, especially if they are subjected to methodological standardization.

Automated summary

Multiple studies have investigated the impact of SARS-CoV-2 infection and COVID-19 severity on various metabolomes to identify diagnostic and prognostic biomarkers. The literature lacks consensus on the utility of metabolomic analyses for COVID-19 management, hence necessitating a critical assessment. Comparing mass spectrometric metabolomic studies on specimens from SARS-CoV2-infected patients, this study aims to identify relevant biomarkers by analyzing clinical design, technical aspects, and statistical analyses. Several metabolites in the plasma of COVID-19 patients may contribute to excessive inflammatory reactions and deficient immune control, revealing significant connections between whole-body metabolism and disease progression. Overall, mass spectrometric approaches show great potential for biomarker discovery if methodological standardization is implemented.