Integrated Metabolic and Inflammatory Signatures Associated with Severity of, Fatality of, and Recovery from COVID-19
Luiz Gustavo Gardinassi, Carolina do Prado Servian, Gesiane da Silva Lima, Déborah Carolina Carvalho dos Anjos, Antônio Roberto Gomes, Adriana Oliveira Guilarde, Moara Alves Santa Bárbara Borges, Gabriel Franco dos Santos, Brenda Grazielli Nogueira Moraes, João Marcos Maia Silva, Letícia Carrijo Masson, Flávia Pereira de Souza, Rodolfo Rodrigues da Silva, Giovanna Lopes de Araújo, Marcella Ferreira Rodrigues, Lidya Cardozo da Silva, Sueli Meira, Fabíola Souza Fiaccadori, Menira Souza, Pedro Roosevelt Torres Romão, Mônica Spadafora Ferreira, Verônica Coelho, Andréa Rodrigues Chaves, Rosineide C. Simas, Boniek G. Vaz, Simone Gonçalves Fonseca
Abstract
COVID-19 is characterized by diverse clinical outcomes that include asymptomatic to mild manifestations or severe disease and death. Infection by SARS-CoV-2 activates inflammatory and metabolic responses that drive protection or pathology. How inflammation and metabolism communicate during COVID-19 is not well defined. We used high-resolution mass spectrometry to investigate small biochemical compounds (<1,500 Da) in plasma of individuals with COVID-19 and controls. Age, sex, and comorbidities have a profound effect on the plasma metabolites of individuals with COVID-19, but we identified significant activity of pathways and metabolites related to amino acids, lipids, nucleotides, and vitamins determined by disease severity, survival outcome, and recovery. Furthermore, we identified metabolites associated with acute-phase proteins and coagulation factors, which collectively identify individuals with severe disease or individuals who died of severe COVID-19. Our study suggests that manipulating specific metabolic pathways can be explored to prevent hyperinflammation, organ dysfunction, and death.