Zhang Shujing, Luo Ping, Xu Juanjuan, Yang Lian, Ma Pei, Tan Xueyun, Chen Qing, Zhou Mei, Song Siwei, Xia Hui, Wang Sufei, Ma Yanling, Yang Fan, Liu Yu, Li Yumei, Ma Guanzhou, Wang Zhihui, Duan Yanran, Jin Yang
Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, People's Republic of China.
Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, People's Republic of China.
J Inflamm Res. 2021 Sep 7;14:4485-4501. doi: 10.2147/JIR.S325853. eCollection 2021.
It remains unclear whether discharged COVID-19 patients have fully recovered from severe complications, including the differences in the post-infection metabolomic profiles of patients with different disease severities.
COVID-19-recovered patients, who had no previous underlying diseases and were discharged from Wuhan Union Hospital for 3 months, and matched healthy controls (HCs) were recruited in this prospective cohort study. We examined the blood biochemical indicators, cytokines, lung computed tomography scans, including 39 HCs, 18 recovered asymptomatic (RAs), 34 recovered moderate (RMs), and 44 recovered severe/ critical patients (RCs). A liquid chromatography-mass spectrometry-based metabolomics approach was employed to profile the global metabolites of fasting plasma of these participants.
Clinical data and metabolomic profiles suggested that RAs recovered well, but some clinical indicators and plasma metabolites in RMs and RCs were still abnormal as compared with HCs, such as decreased taurine, succinic acid, hippuric acid, some indoles, and lipid species. The disturbed metabolic pathway mainly involved the tricarboxylic cycle, purine, and glycerophospholipid metabolism. Moreover, metabolite alterations differ between RMs and RCs when compared with HCs. Correlation analysis revealed that many differential metabolites were closely associated with inflammation and the renal, pulmonary, heart, hepatic, and coagulation system functions.
We uncovered metabolite clusters pathologically relevant to the recovery state in discharged COVID-19 patients which may provide new insights into the pathogenesis of potential organ damage in recovered patients.
新冠病毒病（COVID-19）康复出院患者是否已从严重并发症中完全康复，包括不同疾病严重程度患者感染后的代谢组学特征差异，目前仍不清楚。
在这项前瞻性队列研究中，招募了武汉协和医院出院3个月、无既往基础疾病的COVID-19康复患者以及匹配的健康对照（HC）。我们检测了血液生化指标、细胞因子、肺部计算机断层扫描，包括39名HC、18名康复无症状（RA）患者、34名康复中度（RM）患者和44名康复重度/危重症患者（RC）。采用基于液相色谱-质谱联用的代谢组学方法分析这些参与者空腹血浆中的整体代谢物。
临床数据和代谢组学特征表明，RA患者恢复良好，但与HC相比，RM和RC患者的一些临床指标和血浆代谢物仍异常，如牛磺酸、琥珀酸、马尿酸、一些吲哚和脂质种类减少。受干扰的代谢途径主要涉及三羧酸循环、嘌呤和甘油磷脂代谢。此外，与HC相比，RM和RC患者的代谢物改变有所不同。相关性分析显示，许多差异代谢物与炎症以及肾、肺、心、肝和凝血系统功能密切相关。
我们发现了与COVID-19康复出院患者恢复状态病理相关的代谢物簇，这可能为康复患者潜在器官损伤的发病机制提供新的见解。
