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Published on: December 19, 2020
The Divergent Metabolomic Landscape of COVID-19 and Community-Acquired Pneumonia
Vassiliki Rapti1, Spyros Foutadakis2, Nikolaos Kakavoulis3
1Third Department of Internal Medicine and Laboratory, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
Objectives:
To map and compare the serum metabolome of hospitalized patients with COVID-19 or community-acquired pneumonia (CAP).
Design:
Observational matched cohort study using an untargeted metabolomics approach.
Setting:
Serum samples were obtained at the time of hospital admission as part of two clinical trials conducted in hospitalized patients.
Patients:
A matched cohort design was applied, including patients with COVID-19 and CAP, matched according to age, sex, and Charlson Comorbidity Index. The patient samples were obtained from two clinical studies, namely the suPAR-guided Anakinra Treatment for Validation of the Risk and Management of Respiratory Failure by COVID-19 (SAVE) trial (ClinicalTrials.gov identifier: NCT04357366; European Union Drug Regulating Authorities (EudraCT) number: 2020-001466-11) and the A randomized clinical trial of oral Clarithromycin in Community-acquired pneumonia to attenuatE inflammatory responseS and improve outcomeS (ACCESS trial) (ClinicalTrials.gov identifier: NCT04724044; EudraCT number: 2020-004452-15). The total study population comprised 92 patients.
Interventions:
None.
Measurements And Main Results:
A total of 3555 metabolites were detected, and differential analysis recovered more than 70% of the metabolome as altered between conditions. Metabolite pathway analysis highlighted pathways related to the citric acid cycle and arachidonic metabolism as activated in CAP, while COVID-19 was mainly driven by alterations in amino acid metabolism and metabolites related to mitochondrial function.
Conclusions:
Extensive divergence was observed in the metabolomic landscape of patients with COVID-19 or CAP, underscoring the disease-specific metabolic adaptations and providing potential targets for diagnostic and therapeutic development.
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