Systematic review of amino acid profiles among COVID-19 patients caused by SARS-CoV-2

Emerging evidence highlights the critical role of amino acid metabolism in the pathogenesis and severity of COVID-19. This review included studies encompassing patients with varying degrees of disease severity, from mild to critical cases.

A systematic review following PRISMA guidelines was conducted, and study quality was appraised using the Newcastle-Ottawa tools to explore the relationship between amino acid profiles and clinical outcomes in COVID-19 patients. A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar (from the start of the pandemic through the most recent data available on December 2024) identified peer-reviewed studies reporting original data on amino acid metabolism in COVID-19 patients.

Fourteen eligiblestudies involving 1355 confirmed COVID-19 patients (1726 total participants) were included and revealed significant disruptions inamino acid profiles. Key findings included reduced levels of arginine, glutamine, and tryptophan, alongside elevated phenylalanine andbranched-chain amino acids (BCAAs). These changes were associated with disease severity, immune suppression, systemicinflammation, and metabolic reprogramming. Dysregulation of pathways such as the urea cycle and kynurenine pathway were linked toendothelial dysfunction and immune dysregulation.

Dysregulated amino acid profiles may serve as potential biomarkers for disease severity and require further validation before clinical application. Restoring amino acid balance or modulating metabolic pathways could improve clinical outcomes. Further research is needed to validate these findings and explore personalized treatment strategies aimed at mitigating the metabolic consequences of SARS-CoV-2 infection.

The online version contains supplementary material available at 10.1007/s40200-026-02012-4.