Brigo Natascha, Mayr Wolfram, Taenzer Maja, Löffler-Ragg Judith, Schroll Andrea, Engl Sabine, Schütz Burkhard, Rappl Peter, Heine Till, Weiss Günter, Kurz Katharina
Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.
Biovis Diagnostik, Limburg, Germany.
Front Cell Infect Microbiol. 2025 May 29;15:1582972. doi: 10.3389/fcimb.2025.1582972. eCollection 2025.
Post-COVID-19 syndrome (PCS) is characterized by persistent symptoms and reduced mental and physical performance following the acute phase of COVID-19. The underlying mechanisms remain unclear but may involve gut microbiota dysbiosis and immune-related changes in amino acid metabolism. This pilot study aimed to investigate whether specific bacterial uremic metabolites (BUM) are altered in patients with post-infectious syndromes and whether these alterations are associated with PCS symptoms. We examined BUM in 25 PCS patients, 8 Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) patients, and 8 healthy controls (Ctrls). Concentrations of BUM were determined in second morning urine samples using mass spectrometry (Biovis Diagnostik, Limburg, Germany). Standardized questionnaires assesed physical, cognitive, psychological, and somatic symptoms and mental health status. PCS and ME/CFS patients exhibited significantly higher scores for post-exertional malaise (PEM) and somatic symptom severity compared to healthy controls (p<0.001). Elevated BUM concentrations were found in 64% of PCS patients, compared to 37.5% of both healthy controls and ME/CFS patients. While overall BUM levels did not significantly differ between groups, heatmap clustering revealed distinct metabolic patterns. Elevated tryptamine and 4-hydroxyphenylpropionic acid (HPHPA) and higher hippuric acid and trimethylamine concentrations, were exclusively analysed in patients with post-infectious syndromes. Our pilot study suggests that urine metabolomic analysis may be a useful approach for investigating the role of gut dysbiosis and BUM in patients with PCS.
新冠后综合征（PCS）的特征是在新冠急性期过后出现持续症状以及身心表现下降。其潜在机制尚不清楚，但可能涉及肠道微生物群失调以及氨基酸代谢中的免疫相关变化。这项初步研究旨在调查特定的细菌性尿毒症代谢物（BUM）在感染后综合征患者中是否发生改变，以及这些改变是否与PCS症状相关。我们检测了25例PCS患者、8例肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）患者和8例健康对照者（Ctrl）的BUM。使用质谱法（德国林堡的Biovis Diagnostik公司）测定次日晨尿样本中BUM的浓度。通过标准化问卷评估身体、认知、心理和躯体症状以及心理健康状况。与健康对照者相比，PCS和ME/CFS患者在运动后不适（PEM）和躯体症状严重程度方面的得分显著更高（p<0.001）。64%的PCS患者BUM浓度升高，而健康对照者和ME/CFS患者中这一比例为37.5%。虽然各组之间的总体BUM水平没有显著差异，但热图聚类显示出不同的代谢模式。仅在感染后综合征患者中分析了色胺和4-羟基苯丙酸（HPHPA）升高以及马尿酸和三甲胺浓度升高的情况。我们的初步研究表明，尿液代谢组学分析可能是一种有用的方法，用于研究肠道菌群失调和BUM在PCS患者中的作用。
