期刊
METABOLISM-CLINICAL AND EXPERIMENTAL
卷 118, 期 -, 页码 -出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.metabol.2021.154739
关键词
COVID-19; SARS-CoV-2; Serum metabolome; Predictive value
资金
- Science and Technology Department of Zhejiang Province [2020c03123]
- National Natural Science Foundation of China [81570512, 81790631, 81800457]
- National Key Research and Development Program of China [2018YFC2000500]
- National Science and Technology Major Project [2017ZX10204401]
- Emergency Special Project of the Ministry of Science and Technology [10600100000015001206]
- Chinese Postdoctoral Science Foundation [2020T130101ZX]
- Zhejiang Provincial Natural Science Foundation of China [LED20H190001, LQ19H030007, LQ20H030010]
The serum metabolome of COVID-19 patients is distinctive and can be used for investigating pathogenesis, determining a diagnosis, predicting severe cases, and improving treatment. Specific metabolites were found to distinguish COVID-19 patients from healthy controls and predict disease progression, with some being recovered after discharge.
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-COVID19 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-3methylbutyric 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. (C) 2021 Elsevier Inc. All rights reserved.
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