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评估 COVID-19 患者微量营养素状况、感染风险和临床结局的代谢健康快照。

The snapshot of metabolic health in evaluating micronutrient status, the risk of infection and clinical outcome of COVID-19.

机构信息

European Institute of Nutritional Medicine, 00198 Rome, Italy; Metabolomic Medicine, Health Clinic for Autoimmune and Chronic Diseases, 10674 Athens, Greece.

Metabolomic Medicine, Health Clinic for Autoimmune and Chronic Diseases, 10674 Athens, Greece; Laboratory of Toxicology and Forensic Sciences, Medical School, University of Crete, 71003 Heraklion, Greece.

出版信息

Clin Nutr ESPEN. 2021 Aug;44:173-187. doi: 10.1016/j.clnesp.2021.06.011. Epub 2021 Jun 26.

Abstract

COVID-19 has re-established the significance of analyzing the organism through a metabolic perspective to uncover the dynamic interconnections within the biological systems. The role of micronutrient status and metabolic health emerge as pivotal in COVID-19 pathogenesis and the immune system's response. Metabolic disruption, proceeding from modifiable factors, has been proposed as a significant risk factor accounting for infection susceptibility, disease severity and risk for post-COVID complications. Metabolomics, the comprehensive study and quantification of intermediates and products of metabolism, is a rapidly evolving field and a novel tool in biomarker discovery. In this article, we propose that leveraging insulin resistance biomarkers along with biomarkers of micronutrient deficiencies, will allow for a diagnostic window and provide functional therapeutic targets. Specifically, metabolomics can be applied as: a. At-home test to assess the risk of infection and propose nutritional support, b. A screening tool for high-risk COVID-19 patients to develop serious illness during hospital admission and prioritize medical support, c(i). A tool to match nutritional support with specific nutrient requirements for mildly ill patients to reduce the risk for hospitalization, and c(ii). for critically ill patients to reduce recovery time and risk of post-COVID complications, d. At-home test to monitor metabolic health and reduce post-COVID symptomatology. Metabolic rewiring offers potential virtues towards disease prevention, dissection of high-risk patients, taking actionable therapeutic measures, as well as shielding against post-COVID syndrome.

摘要

COVID-19 重新确立了通过代谢角度分析机体以揭示生物系统内部动态关联的重要性。微量营养素状态和代谢健康的作用在 COVID-19 发病机制和免疫系统反应中显得至关重要。代谢紊乱是由可改变的因素引起的,被认为是感染易感性、疾病严重程度和 COVID 后并发症风险的重要危险因素。代谢组学是对代谢中间产物和产物的全面研究和定量,是一个快速发展的领域,也是生物标志物发现的新工具。在本文中,我们提出利用胰岛素抵抗生物标志物和微量营养素缺乏生物标志物,可以为诊断提供窗口,并提供功能性治疗靶点。具体来说,代谢组学可以应用于:a. 家庭测试以评估感染风险并提出营养支持建议,b. 对 COVID-19 高危患者进行筛查,以确定住院期间是否会发生严重疾病并优先提供医疗支持,c(i). 为轻度感染患者提供匹配营养支持和特定营养素需求的工具,以降低住院风险,c(ii). 为重症患者提供工具,以缩短康复时间并降低 COVID 后并发症风险,d. 家庭测试以监测代谢健康并降低 COVID 后症状。代谢重编程为疾病预防、高危患者剖析、采取可行的治疗措施以及预防 COVID 后综合征提供了潜在的优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b345/8234252/aece2fefd800/ga1_lrg.jpg

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