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Alteration of Plasma Amino Acid Concentrations in Iranian Children with COVID-19
Sedigheh Shams1,2, Aileen Azari-Yam3, Moeinadin Safavi3
1Pathology Department, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
COVID-19 alters plasma amino acid levels, with higher levels of several amino acids and lower glutamine in patients. Low isoleucine predicts mortality in severe COVID-19 cases.
Area of Science:
- Biochemistry
- Immunology
- Infectious Diseases
Background:
- COVID-19, a global pandemic, significantly impacts the immune system and various organs.
- Understanding metabolic alterations, such as changes in amino acid profiles, is crucial for managing COVID-19.
- Previous research indicates potential links between disease severity and metabolic changes.
Purpose of the Study:
- To investigate and compare free plasma amino acid levels in COVID-19 patients versus non-COVID-19 subjects.
- To analyze amino acid level differences between critically ill (intensive care unit - ICU) and non-ICU COVID-19 patients.
- To identify amino acid level correlations with patient outcomes, including mortality and recovery.
Main Methods:
- Plasma samples were collected from 26 COVID-19 patients and 32 non-COVID-19 controls.
- Amino acid concentrations were quantified and compared between groups using statistical analysis.
- Logistic regression was employed to assess amino acid levels as predictors of mortality.
Main Results:
- Significant elevations in glutamic acid, serine, glycine, threonine, phenylalanine, leucine, lysine, alanine, arginine, aspartic acid, and ornithine were observed in COVID-19 patients.
- Glutamine levels were significantly lower in COVID-19 patients compared to controls.
- Low glutamine and isoleucine levels were prevalent in ICU and expired patients, respectively. Low isoleucine was a significant predictor of mortality (P=0.02).
Conclusions:
- Plasma amino acid concentrations are significantly altered in COVID-19 patients.
- These metabolic changes, particularly low glutamine and isoleucine, are more pronounced in critically ill and non-surviving patients.
- Amino acid profiling may offer insights into COVID-19 severity and patient prognosis.
Abstract:
COVID-19 is an acute viral disease that has so far infected more than 200 million and killed more than four million worldwide. It affects the immune system and other organs. Here, we investigated the level of free plasma amino acids in COVID-19 patients and compared them with non-COVID-19 subjects. We also compared amino acids levels in critically ill patients admitted to the intensive care unit (ICU) with non-ICU patients and expired and recovered patients. Twenty-six COVID-19 patients and 32 non-COVID-19 subjects were included in the study. The mean of glutamic acid, serine, glycine, threonine, phenylalanine, leucine, lysine, alanine, arginine, aspartic acid, and ornithine was significantly higher in cases than controls. In addition, the mean of glutamine was significantly lower in patients than controls (443.89 ± 254.31 vs. 651.73 ± 107.38, PV < 0.001). Low level of glutamine and isoleucine was seen in the majority of ICU and expired patients, respectively. Logistic regression analysis showed low level of isoleucine as a predictor variable in mortality (P = 0.02, EXP (B) = 16.5, and CI 95% = (1.48, -183.07)). There was a positive and significant relationship between some amino acids levels, serum liver enzymes, and sodium concentrations. There was also a significant but negative correlation between histidine levels, ESR, and ferritin. Phenylalanine had a highly positive relationship with serum procalcitonin in patients (R 2 = 0.534, PV = 0.015). Our studies have shown the alteration of plasma amino acids concentration in COVID-19 patients. These changes are more evident in critically ill and at-risk patients.
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