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Dillard LR, Wase N, Ramakrishnan G, Park JJ, Sherman NE, Carpenter R, Young M, Donlan AN, Petri W, Papin JA. Leveraging metabolic modeling to identify functional metabolic alterations associated with COVID-19 disease severity. Metabolomics 2022; 18:51. [PMID: 35819731 PMCID: PMC9273921 DOI: 10.1007/s11306-022-01904-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 06/01/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Since the COVID-19 pandemic began in early 2020, SARS-CoV2 has claimed more than six million lives world-wide, with over 510 million cases to date. To reduce healthcare burden, we must investigate how to prevent non-acute disease from progressing to severe infection requiring hospitalization. METHODS To achieve this goal, we investigated metabolic signatures of both non-acute (out-patient) and severe (requiring hospitalization) COVID-19 samples by profiling the associated plasma metabolomes of 84 COVID-19 positive University of Virginia hospital patients. We utilized supervised and unsupervised machine learning and metabolic modeling approaches to identify key metabolic drivers that are predictive of COVID-19 disease severity. Using metabolic pathway enrichment analysis, we explored potential metabolic mechanisms that link these markers to disease progression. RESULTS Enriched metabolites associated with tryptophan in non-acute COVID-19 samples suggest mitigated innate immune system inflammatory response and immunopathology related lung damage prevention. Increased prevalence of histidine- and ketone-related metabolism in severe COVID-19 samples offers potential mechanistic insight to musculoskeletal degeneration-induced muscular weakness and host metabolism that has been hijacked by SARS-CoV2 infection to increase viral replication and invasion. CONCLUSIONS Our findings highlight the metabolic transition from an innate immune response coupled with inflammatory pathway inhibition in non-acute infection to rampant inflammation and associated metabolic systemic dysfunction in severe COVID-19.
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Affiliation(s)
- L R Dillard
- Department of Biochemistry & Molecular Genetics, University of Virginia, Charlottesville, VA, 22908, USA
| | - N Wase
- School of Medicine Core Facilities, University of Virginia, Charlottesville, VA, 22908, USA
| | - G Ramakrishnan
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, 22908, USA
| | - J J Park
- School of Medicine Core Facilities, University of Virginia, Charlottesville, VA, 22908, USA
| | - N E Sherman
- School of Medicine Core Facilities, University of Virginia, Charlottesville, VA, 22908, USA
| | - R Carpenter
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, 22908, USA
| | - M Young
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, 22908, USA
| | - A N Donlan
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, 22908, USA
| | - W Petri
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, 22908, USA
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia Health System, Charlottesville, VA, 22908, USA
| | - J A Papin
- Department of Biochemistry & Molecular Genetics, University of Virginia, Charlottesville, VA, 22908, USA.
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, 22908, USA.
- Department of Biomedical Engineering, University of Virginia, Health System, Box 800759, Charlottesville, VA, 22908, USA.
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