Plasma Metabolomic Profiles in Recovered COVID-19 Patients without Previous Underlying Diseases 3 Months After Discharge

Abstract

Background: It remains unclear whether discharged COVID-19 patients have fully recovered from severe complications, including the differences in the post-infection metabolomic profiles of patients with different disease severities. Methods: COVID-19-recovered patients, who had no previous underlying diseases and were discharged from Wuhan Union Hospital for 3 months, and matched healthy controls (HCs) were recruited in this prospective cohort study. We examined the blood biochemical indicators, cytokines, lung computed tomography scans, including 39 HCs, 18 recovered asymptomatic (RAs), 34 recovered moderate (RMs), and 44 recovered severe/ critical patients (RCs). A liquid chromatography-mass spectrometry-based metabolomics approach was employed to profile the global metabolites of fasting plasma of these participants. Results: Clinical data and metabolomic profiles suggested that RAs recovered well, but some clinical indicators and plasma metabolites in RMs and RCs were still abnormal as compared with HCs, such as decreased taurine, succinic acid, hippuric acid, some indoles, and lipid species. The disturbed metabolic pathway mainly involved the tricarboxylic cycle, purine, and glycerophospholipid metabolism. Moreover, metabolite alterations differ between RMs and RCs when compared with HCs. Correlation analysis revealed that many differential metabolites were closely associated with inflammation and the renal, pulmonary, heart, hepatic, and coagulation system functions. Conclusion:We uncovered metabolite clusters pathologically relevant to the recovery state in discharged COVID-19 patients which may provide new insights into the pathogenesis of potential organ damage in recovered patients.

Persistence of Metabolomic Changes in Patients during Post-COVID Phase: A Prospective, Observational Study

“…Changes in the level of serum metabolites and lipidemic profile [ 7 ] in COVID-19 patients may reflect and reveal specific pathological processes that affect not only the lung tissue but entire organisms [ 8 , 9 ]. Despite some evidence that serum metabolite levels change during the acute SARS-CoV-2 infection, data describing their levels after the acute phase are scarce [ 10 , 11 , 12 ]. Therefore, the aim of this study was to analyze the metabolite profile of patients who suffered from a clinically moderate to serious course of COVID-19 approximately one month after the acute infection and to compare these results with healthy (SARS-CoV-2-negative) controls.…”

Direct low field J-edited diffusional proton NMR spectroscopic measurement of COVID-19 inflammatory biomarkers in human serum

“…39,40 Many of these pathological changes can be observed using a variety of NMR experiments on blood plasma and these changes are robust to sample handling with standardised protocols 41,42 and were also observed by others. 22,43–45…”

Small-molecule metabolome identifies potential therapeutic targets against COVID-19

“…Studies regarding succinic acid in the context of COVID-19 in respect to other respiratory infection are lacking. Moreover while compared to healthy controls succinic acid was enriched in the serum of patients with COVID-19 34 subjects who had recovered from COVID-19 infection but had a moderate and severe or critical illness 3 months after discharge had decreased plasma levels of succinic acid compared to healthy controls 49 . Further investigation will be needed to identify the significance of lower MetSO and succinic acid in COVID-19 infection.…”