Metabolomic/lipidomic profiling of COVID-19 and individual response to tocilizumab

• Published in: PLoS pathogens Vol. 17; no. 2; p. e1009243
• Main Authors: Meoni, Gaia, Ghini, Veronica, Maggi, Laura, Vignoli, Alessia, Mazzoni, Alessio, Salvati, Lorenzo, Capone, Manuela, Vanni, Anna, Tenori, Leonardo, Fontanari, Paolo, Lavorini, Federico, Peris, Adriano, Bartoloni, Alessandro, Liotta, Francesco, Cosmi, Lorenzo, Luchinat, Claudio, Annunziato, Francesco, Turano, Paola
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.02.2021; Public Library of Science (PLoS)
• Subjects: Accuracy; Antibodies, Monoclonal, Humanized - administration & dosage; Biology and Life Sciences; Blood cells; Carboxylates; Cardiovascular disease; Cholesterol; Citric acid; Coronary artery; Coronary artery disease; Coronaviruses; COVID-19; COVID-19 - blood; COVID-19 - drug therapy; COVID-19 - epidemiology; Cytokines; Erythrocytes; Ethylenediaminetetraacetic acids; Female; Heart diseases; High density lipoprotein; Humans; Hypoxia; Immunosuppressive agents; Infections; Intensive care; Lipidomics; Lipids; Lipids - blood; Low density lipoprotein; Male; Medicine and Health Sciences; Metabolites; Metabolomics; Monoclonal antibodies; Neutrophils; NMR; NMR spectroscopy; Nuclear magnetic resonance; Nuclear Magnetic Resonance, Biomolecular; Pandemics; Patients; Phenylalanine; Plasma; Pneumonia; Principal components analysis; Research and analysis methods; SARS-CoV-2 - metabolism; Sepsis; Severe acute respiratory syndrome coronavirus 2; Spectroscopy; Spectrum analysis; Tyrosine; Ventilators
• ISSN: 1553-7374; 1553-7366; 1553-7374
• DOI: 10.1371/journal.ppat.1009243

The current pandemic emergence of novel coronavirus disease (COVID-19) poses a relevant threat to global health. SARS-CoV-2 infection is characterized by a wide range of clinical manifestations, ranging from absence of symptoms to severe forms that need intensive care treatment. Here, plasma-EDTA samples of 30 patients compared with age- and sex-matched controls were analyzed via untargeted nuclear magnetic resonance (NMR)-based metabolomics and lipidomics. With the same approach, the effect of tocilizumab administration was evaluated in a subset of patients. Despite the heterogeneity of the clinical symptoms, COVID-19 patients are characterized by common plasma metabolomic and lipidomic signatures (91.7% and 87.5% accuracy, respectively, when compared to controls). Tocilizumab treatment resulted in at least partial reversion of the metabolic alterations due to SARS-CoV-2 infection. In conclusion, NMR-based metabolomic and lipidomic profiling provides novel insights into the pathophysiological mechanism of human response to SARS-CoV-2 infection and to monitor treatment outcomes.