State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003, Hangzhou, China.
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310003, Hangzhou, China.
Anal Chim Acta. 2021 Apr 1;1152:338267. doi: 10.1016/j.aca.2021.338267. Epub 2021 Jan 31.
Although SARS-CoV-2 can invade the intestine, though its effect on digestion and absorption is not fully understood. In the present study, 56 COVID-19 patients and 47 age- and sex-matched healthy subjects were divided into a discovery cohort and a validation cohort. Blood, faeces and clinical information were collected from the patients in the hospital and at discharge. The faecal metabolome was analysed using gas chromatography-mass spectrometry, and Spearman's correlation analyses of clinical features, the serum metabolome, and the faecal micro- and mycobiota were conducted. The results showed that, the faeces of COVID-19 patients were enriched with important nutrients that should be metabolized or absorbed, such as sucrose and 2-palmitoyl-glycerol; diet-related components that cannot be synthesized by humans, such as 1,5-anhydroglucitol and D-pinitol; and harmful metabolites, such as oxalate, were also detected. In contrast, purine metabolites such as deoxyinosine and hypoxanthine, low-water-soluble long-chain fatty alcohols/acids such as behenic acid, compounds rarely occurring in nature such as D-allose and D-arabinose, and microbe-related compounds such as 2,4-di-tert-butylphenol were depleted in the faeces of COVID-19 patients. Moreover, these metabolites significantly correlated with altered serum metabolites such as oxalate and gut microbesincluding Ruminococcaceae, Actinomyces, Sphingomonas and Aspergillus. Although levels of several faecal metabolites, such as sucrose, 1,5-anhydroglucitol and D-pinitol, of discharged patients were not different from those of healthy controls (HCs), those of oxalate and 2-palmitoyl-glycerol did differ. Therefore, alterations in the faecal metabolome of COVID-19 patients may reflect malnutrition and intestinal inflammation and warrant greater attention. The results of present study provide new insights into the pathogenesis and treatment of COVID-19.
虽然 SARS-CoV-2 可以入侵肠道，但它对消化和吸收的影响尚未完全阐明。本研究纳入 56 例 COVID-19 患者和 47 例年龄、性别匹配的健康对照，分为发现队列和验证队列。在住院和出院时收集患者的血液、粪便和临床信息。采用气相色谱-质谱法分析粪便代谢组学，并对临床特征、血清代谢组学和粪便微生物组和真菌组进行 Spearman 相关分析。结果显示，COVID-19 患者的粪便中富含重要的营养物质，如蔗糖和 2-棕榈酰甘油；人类不能合成的饮食相关成分，如 1,5-脱水葡萄糖醇和 D-松醇；以及有害代谢物，如草酸盐。相比之下，嘌呤代谢物如脱氧肌苷和次黄嘌呤、低水溶性长链脂肪醇/酸如正二十二烷酸、自然界中很少出现的化合物如 D-阿洛糖和 D-阿拉伯糖以及与微生物相关的化合物如 2,4-二叔丁基苯酚在 COVID-19 患者的粪便中被耗尽。此外，这些代谢物与血清代谢物（如草酸盐）和肠道微生物（包括瘤胃球菌科、放线菌、鞘氨醇单胞菌和曲霉）的改变显著相关。虽然出院患者的粪便中几种代谢物（如蔗糖、1,5-脱水葡萄糖醇和 D-松醇）的水平与健康对照（HCs）无差异，但草酸盐和 2-棕榈酰甘油的水平不同。因此，COVID-19 患者粪便代谢组的改变可能反映营养不良和肠道炎症，需要引起更多关注。本研究结果为 COVID-19 的发病机制和治疗提供了新的见解。
