A ‘Multiomic’ Approach of Saliva Metabolomics, Microbiota, and Serum Biomarkers to Assess the Need of Hospitalization in Coronavirus Disease 2019
Chiara Pozzi, Riccardo Levi, Daniele Braga, Francesco Carli, Abbass Darwich, Ilaria Spadoni, Bianca Oresta, Carola Conca Dioguardi, Clelia Peano, Leonardo Ubaldi, Giovanni Angelotti, Barbara Bottazzi, Cecília Garlanda, Antonio Desai, Antonio Voza, Elena Azzolini, Maurizio Cecconi, Alessio Aghemo, Anfray Clement, Salvatore Badalamenti, Cristina Belgiovine, Alice Bertocchi, Sara Bombace, Paola Brescia, Francesca Calcaterra, Michela Calvi, Cancellara Assunta, Arianna Capucetti, Carenza Claudia, Sara Carloni, Silvia Carnevale, Valentina Cazzetta, Cecconi Maurizio, Michele Ciccarelli, Coianiz Nicolò, Abbass Darwich, Lleo De Nalda Ana, De Paoli Federica, Di Donato Rachele, Digifico Elisabeth, Barbara Durante, FARINA Floriana Maria, Valentina Ferrari, Giulia Fornasa, Franzese Sara, Gil Gomez Antonio, Silvia Giugliano, Gomes Ana Rita, Michela Lizier, Lo Cascio Antonino, Alessia Melacarne, Alessandro M. Mozzarelli, Ilaria My, Bianca Oresta, Fabio Pasqualini, Anna Pastò, Pelamatti Erica, Chiara Perucchini, Pozzi Chiara, Valeria Rimoldi, Rimoldi Monica, Scarpa Alice, Selmi Carlo, Alessandra Silvestri, Sironi Marina, Ilaria Spadoni, Salvatore Spanò, Gianmarco Spata, Domenico Supino, Tentorio Paolo, Aldo Ummarino, Sonia Valentino, Voza Antonio, Elisa Zaghi, Veronica Zanon, Alberto Mantovani, Giuseppe Penna, Riccardo Barbieri, Letterio S. Politi, María Rescigno
Abstract
BACKGROUND AND AIMS: The SARS-CoV-2 pandemic has overwhelmed the treatment capacity of the health care systems during the highest viral diffusion rate. Patients reaching the emergency department had to be either hospitalized (inpatients) or discharged (outpatients). Still, the decision was taken based on the individual assessment of the actual clinical condition, without specific biomarkers to predict future improvement or deterioration, and discharged patients often returned to the hospital for aggravation of their condition. Here, we have developed a new combined approach of omics to identify factors that could distinguish coronavirus disease 19 (COVID-19) inpatients from outpatients. METHODS: Saliva and blood samples were collected over the course of two observational cohort studies. By using machine learning approaches, we compared salivary metabolome of 50 COVID-19 patients with that of 270 healthy individuals having previously been exposed or not to SARS-CoV-2. We then correlated the salivary metabolites that allowed separating COVID-19 inpatients from outpatients with serum biomarkers and salivary microbiota taxa differentially represented in the two groups of patients. RESULTS: were all underrepresented in the hospitalized population. CONCLUSION: This is a proof of concept that a combined omic analysis can be used to stratify patients independently from COVID-19.