Frontiers in Immunology (Jul 2022)

Metabolic Reprogramming in SARS-CoV-2 Infection Impacts the Outcome of COVID-19 Patients

  • Laura E. Martínez-Gómez,
  • Isabel Ibarra-González,
  • Cynthia Fernández-Lainez,
  • Teresa Tusie,
  • Hortensia Moreno-Macías,
  • Hortensia Moreno-Macías,
  • Carlos Martinez-Armenta,
  • Guadalupe Elizabeth Jimenez-Gutierrez,
  • Paola Vázquez-Cárdenas,
  • Patricia Vidal-Vázquez,
  • Juan P. Ramírez-Hinojosa,
  • Ana P. Rodríguez-Zulueta,
  • Gilberto Vargas-Alarcón,
  • Gustavo Rojas-Velasco,
  • Fausto Sánchez-Muñoz,
  • Rosalinda Posadas-Sanchez,
  • Felipe de J. Martínez-Ruiz,
  • Dulce M. Zayago-Angeles,
  • Mariana L. Moreno,
  • Edith Barajas-Galicia,
  • Gerardo Lopez-Cisneros,
  • Nadia C. Gonzalez-Fernández,
  • Silvestre Ortega-Peña,
  • Brígida Herrera-López,
  • Jessel Olea-Torres,
  • Manuel Juárez-Arias,
  • Maritza Rosas-Vásquez,
  • Sara Aileen Cabrera-Nieto,
  • Jonathan J. Magaña,
  • María del Carmen Camacho-Rea,
  • Carlos Suarez-Ahedo,
  • Irma Coronado-Zarco,
  • M. Y. Valdespino-Vázquez,
  • Gabriela Angélica Martínez-Nava,
  • Carlos Pineda,
  • Marcela Vela-Amieva,
  • Alberto López-Reyes,
  • Mex-Gen-COVID Initiative Group

DOI
https://doi.org/10.3389/fimmu.2022.936106
Journal volume & issue
Vol. 13

Abstract

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IntroductionSevere acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) infection triggers inflammatory clinical stages that affect the outcome of patients with coronavirus disease 2019 (COVID-19). Disease severity may be associated with a metabolic imbalance related to amino acids, lipids, and energy-generating pathways. The aim of this study was to characterize the profile of amino acids and acylcarnitines in COVID-19 patients. A multicenter, cross-sectional study was carried out. A total of 453 individuals were classified by disease severity. Levels of 11 amino acids, 31 acylcarnitines, and succinylacetone in serum samples were analyzed by electrospray ionization–triple quadrupole tandem mass spectrometry. Different clusters were observed in partial least squares discriminant analysis, with phenylalanine, alanine, citrulline, proline, and succinylacetone providing the major contribution to the variability in each cluster (variable importance in the projection >1.5). In logistic models adjusted by age, sex, type 2 diabetes mellitus, hypertension, and nutritional status, phenylalanine was associated with critical outcomes (odds ratio=5.3 (95% CI 3.16-9.2) in the severe vs. critical model, with an area under the curve of 0.84 (95% CI 0.77-0.90). In conclusion the metabolic imbalance in COVID-19 patients might affect disease progression. This work shows an association of phenylalanine with critical outcomes in COVID-19 patients, highlighting phenylalanine as a potential metabolic biomarker of disease severity.

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