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Tracking COVID-19 Severity and Progression Through Amines and Lipid Mediators
Melissa Goris1, Merys Valdez1, Lieke Lamont1
1Metabolomics and Analytics Center, Leiden Academic Center for Drug Research (LACDR), Leiden University, Leiden, The Netherlands.
Insights
Longitudinal metabolomic profiling reveals key metabolic shifts associated with COVID-19 severity and progression. These findings may identify at-risk patients and offer novel therapeutic targets for coronavirus disease 2019.
Area of Science:
- Metabolomics
- Infectious Diseases
- Biochemistry
Background:
- Coronavirus disease 2019 (COVID-19) presents a wide range of clinical severity.
- Early interventions for high-risk patients are crucial to reduce mortality and healthcare costs.
Purpose of the Study:
- To investigate the association between longitudinal metabolomic profiles and the severity and progression of COVID-19.
- To identify potential metabolic biomarkers for predicting COVID-19 outcomes.
Main Methods:
- Analysis of metabolomic profiles from hospitalized COVID-19 patients in the BEAT-COVID cohort, sampled longitudinally over up to 60 days.
- Daily assessment of disease severity using the Severity of Coronavirus Disease Assessment (SCODA) score.
- Statistical analysis using linear mixed-effect models to identify associations between metabolites and disease severity.
Main Results:
- Significant perturbations were observed in the tryptophan-kynurenine pathway, linoleic acid derivatives, endocannabinoids, and sphingosines, correlating with COVID-19 severity and progression.
- Metabolic changes were associated with immune markers indicative of COVID-19 severity.
- Potential differences between study waves may be linked to corticosteroid treatment.
Conclusions:
- Longitudinal metabolomic profiling can reveal key metabolic alterations in COVID-19 patients.
- Identified metabolites related to oxidative stress and inflammation may serve as biomarkers for disease progression.
- These findings could aid in identifying at-risk patients and suggest potential therapeutic targets for COVID-19.
Abstract:
Coronavirus disease 2019 (COVID-19) exhibits a broad spectrum of severity, ranging from mild to critical cases. To reduce mortality and costs, tailored early interventions for at-risk patients are essential. This study elucidates the association between longitudinal metabolomic profiles and COVID-19 severity and progression. We analyzed metabolomic profiles from a subset of the BEAT-COVID cohort, a modestly sized yet well-characterized and longitudinally sampled COVID-19 cohort. The study comprises hospitalized patients sampled approximately twice weekly for up to 60 days after symptom onset during the first (29 patients, n = 92 samples) and second (48 patients, n = 112 samples) waves. Alongside sampling, daily disease severity was assessed using the Severity of Coronavirus Disease Assessment (SCODA) score. Associations were analyzed using univariate and multivariate linear mixed-effect models. Perturbations in the tryptophan-kynurenine pathway, linoleic acid derivatives, endocannabinoids, and sphingosines were significantly associated with disease severity and progression. These metabolic changes correlated with immune markers reflecting COVID-19 severity. Some observed potential differences between the two waves could be partially attributed to the influence of corticosteroid treatment introduced during the second wave. Once confirmed in an independent validation cohort, the identified oxidative stress- and inflammation-related metabolites may serve as biomarkers of disease progression, help identify at-risk hospitalized patients, and provide potential therapeutic targets.
