The plasma metabolome of long COVID patients two years after infection

• Published in: Scientific reports Vol. 13; no. 1; p. 12420
• Main Authors: López-Hernández, Yamilé, Monárrez-Espino, Joel, López, David Alejandro García, Zheng, Jiamin, Borrego, Juan Carlos, Torres-Calzada, Claudia, Elizalde-Díaz, José Pedro, Mandal, Rupasri, Berjanskii, Mark, Martínez-Martínez, Eduardo, López, Jesús Adrián, Wishart, David S.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.08.2023; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4017; 692/53; 692/699; Chromatography, Liquid; Citrulline; COVID-19; Energy metabolism; Global health; Humanities and Social Sciences; Humans; Interleukin 17; Lactic acid; Leptin; Metabolites; Metabolome; Metabolomics; multidisciplinary; Ornithine; Post-Acute COVID-19 Syndrome; Public health; Pyruvic acid; Redox properties; SARS-CoV-2; Science; Science (multidisciplinary); Severe acute respiratory syndrome coronavirus 2; Tandem Mass Spectrometry
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-39049-x

One of the major challenges currently faced by global health systems is the prolonged COVID-19 syndrome (also known as “long COVID”) which has emerged as a consequence of the SARS-CoV-2 epidemic. It is estimated that at least 30% of patients who have had COVID-19 will develop long COVID. In this study, our goal was to assess the plasma metabolome in a total of 100 samples collected from healthy controls, COVID-19 patients, and long COVID patients recruited in Mexico between 2020 and 2022. A targeted metabolomics approach using a combination of LC–MS/MS and FIA MS/MS was performed to quantify 108 metabolites. IL-17 and leptin were measured in long COVID patients by immunoenzymatic assay. The comparison of paired COVID-19/long COVID-19 samples revealed 53 metabolites that were statistically different. Compared to controls, 27 metabolites remained dysregulated even after two years. Post-COVID-19 patients displayed a heterogeneous metabolic profile. Lactic acid, lactate/pyruvate ratio, ornithine/citrulline ratio, and arginine were identified as the most relevant metabolites for distinguishing patients with more complicated long COVID evolution. Additionally, IL-17 levels were significantly increased in these patients. Mitochondrial dysfunction, redox state imbalance, impaired energy metabolism, and chronic immune dysregulation are likely to be the main hallmarks of long COVID even two years after acute COVID-19 infection.