Metabolic and Lipidomic Markers Differentiate COVID-19 From Non-Hospitalized and Other Intensive Care Patients

Coronavirus disease 2019 (COVID-19) is a viral infection affecting multiple organ systems of great significance for metabolic processes. Thus, there is increasing interest in metabolic and lipoprotein signatures of the disease, and early analyses have demonstrated a metabolic pattern typical for ath...

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Published in:Frontiers in molecular biosciences Vol. 8; p. 737039
Main Authors: Schmelter, Franziska, Föh, Bandik, Mallagaray, Alvaro, Rahmöller, Johann, Ehlers, Marc, Lehrian, Selina, von Kopylow, Vera, Künsting, Inga, Lixenfeld, Anne Sophie, Martin, Emily, Ragab, Mohab, Meyer-Saraei, Roza, Kreutzmann, Fabian, Eitel, Ingo, Taube, Stefan, Käding, Nadja, Jantzen, Eckard, Graf, Tobias, Sina, Christian, Günther, Ulrich L.
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Language:English
Published: Switzerland Frontiers Media S.A 02.12.2021
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Abstract Coronavirus disease 2019 (COVID-19) is a viral infection affecting multiple organ systems of great significance for metabolic processes. Thus, there is increasing interest in metabolic and lipoprotein signatures of the disease, and early analyses have demonstrated a metabolic pattern typical for atherosclerotic and hepatic damage in COVID-19 patients. However, it remains unclear whether this is specific for COVID-19 and whether the observed signature is caused by the disease or rather represents an underlying risk factor. To answer this question, we have analyzed 482 serum samples using nuclear magnetic resonance metabolomics, including longitudinally collected samples from 12 COVID-19 and 20 cardiogenic shock intensive care patients, samples from 18 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody-positive individuals, and single time point samples from 58 healthy controls. COVID-19 patients showed a distinct metabolic serum profile, including changes typical for severe dyslipidemia and a deeply altered metabolic status compared with healthy controls. Specifically, very-low-density lipoprotein and intermediate-density lipoprotein particles and associated apolipoprotein B and intermediate-density lipoprotein cholesterol were significantly increased, whereas cholesterol and apolipoprotein A2 were decreased. Moreover, a similarly perturbed profile was apparent when compared with other patients with cardiogenic shock who are in the intensive care unit when looking at a 1-week time course, highlighting close links between COVID-19 and lipid metabolism. The metabolic profile of COVID-19 patients distinguishes those from healthy controls and also from patients with cardiogenic shock. In contrast, anti-SARS-CoV-2 antibody-positive individuals without acute COVID-19 did not show a significantly perturbed metabolic profile compared with age- and sex-matched healthy controls, but SARS-CoV-2 antibody-titers correlated significantly with metabolic parameters, including levels of glycine, ApoA2, and small-sized low- and high-density lipoprotein subfractions. Our data suggest that COVID-19 is associated with dyslipidemia, which is not observed in anti-SARS-CoV-2 antibody-positive individuals who have not developed severe courses of the disease. This suggests that lipoprotein profiles may represent a confounding risk factor for COVID-19 with potential for patient stratification.
AbstractList Coronavirus disease 2019 (COVID-19) is a viral infection affecting multiple organ systems of great significance for metabolic processes. Thus, there is increasing interest in metabolic and lipoprotein signatures of the disease, and early analyses have demonstrated a metabolic pattern typical for atherosclerotic and hepatic damage in COVID-19 patients. However, it remains unclear whether this is specific for COVID-19 and whether the observed signature is caused by the disease or rather represents an underlying risk factor. To answer this question, we have analyzed 482 serum samples using nuclear magnetic resonance metabolomics, including longitudinally collected samples from 12 COVID-19 and 20 cardiogenic shock intensive care patients, samples from 18 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody-positive individuals, and single time point samples from 58 healthy controls. COVID-19 patients showed a distinct metabolic serum profile, including changes typical for severe dyslipidemia and a deeply altered metabolic status compared with healthy controls. Specifically, very-low-density lipoprotein and intermediate-density lipoprotein particles and associated apolipoprotein B and intermediate-density lipoprotein cholesterol were significantly increased, whereas cholesterol and apolipoprotein A2 were decreased. Moreover, a similarly perturbed profile was apparent when compared with other patients with cardiogenic shock who are in the intensive care unit when looking at a 1-week time course, highlighting close links between COVID-19 and lipid metabolism. The metabolic profile of COVID-19 patients distinguishes those from healthy controls and also from patients with cardiogenic shock. In contrast, anti-SARS-CoV-2 antibody-positive individuals without acute COVID-19 did not show a significantly perturbed metabolic profile compared with age- and sex-matched healthy controls, but SARS-CoV-2 antibody-titers correlated significantly with metabolic parameters, including levels of glycine, ApoA2, and small-sized low- and high-density lipoprotein subfractions. Our data suggest that COVID-19 is associated with dyslipidemia, which is not observed in anti-SARS-CoV-2 antibody-positive individuals who have not developed severe courses of the disease. This suggests that lipoprotein profiles may represent a confounding risk factor for COVID-19 with potential for patient stratification.
Coronavirus disease 2019 (COVID-19) is a viral infection affecting multiple organ systems of great significance for metabolic processes. Thus, there is increasing interest in metabolic and lipoprotein signatures of the disease, and early analyses have demonstrated a metabolic pattern typical for atherosclerotic and hepatic damage in COVID-19 patients. However, it remains unclear whether this is specific for COVID-19 and whether the observed signature is caused by the disease or rather represents an underlying risk factor. To answer this question, we have analyzed 482 serum samples using nuclear magnetic resonance metabolomics, including longitudinally collected samples from 12 COVID-19 and 20 cardiogenic shock intensive care patients, samples from 18 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody-positive individuals, and single time point samples from 58 healthy controls. COVID-19 patients showed a distinct metabolic serum profile, including changes typical for severe dyslipidemia and a deeply altered metabolic status compared with healthy controls. Specifically, very-low-density lipoprotein and intermediate-density lipoprotein particles and associated apolipoprotein B and intermediate-density lipoprotein cholesterol were significantly increased, whereas cholesterol and apolipoprotein A2 were decreased. Moreover, a similarly perturbed profile was apparent when compared with other patients with cardiogenic shock who are in the intensive care unit when looking at a 1-week time course, highlighting close links between COVID-19 and lipid metabolism. The metabolic profile of COVID-19 patients distinguishes those from healthy controls and also from patients with cardiogenic shock. In contrast, anti-SARS-CoV-2 antibody-positive individuals without acute COVID-19 did not show a significantly perturbed metabolic profile compared with age- and sex-matched healthy controls, but SARS-CoV-2 antibody-titers correlated significantly with metabolic parameters, including levels of glycine, ApoA2, and small-sized low- and high-density lipoprotein subfractions. Our data suggest that COVID-19 is associated with dyslipidemia, which is not observed in anti-SARS-CoV-2 antibody-positive individuals who have not developed severe courses of the disease. This suggests that lipoprotein profiles may represent a confounding risk factor for COVID-19 with potential for patient stratification.Coronavirus disease 2019 (COVID-19) is a viral infection affecting multiple organ systems of great significance for metabolic processes. Thus, there is increasing interest in metabolic and lipoprotein signatures of the disease, and early analyses have demonstrated a metabolic pattern typical for atherosclerotic and hepatic damage in COVID-19 patients. However, it remains unclear whether this is specific for COVID-19 and whether the observed signature is caused by the disease or rather represents an underlying risk factor. To answer this question, we have analyzed 482 serum samples using nuclear magnetic resonance metabolomics, including longitudinally collected samples from 12 COVID-19 and 20 cardiogenic shock intensive care patients, samples from 18 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody-positive individuals, and single time point samples from 58 healthy controls. COVID-19 patients showed a distinct metabolic serum profile, including changes typical for severe dyslipidemia and a deeply altered metabolic status compared with healthy controls. Specifically, very-low-density lipoprotein and intermediate-density lipoprotein particles and associated apolipoprotein B and intermediate-density lipoprotein cholesterol were significantly increased, whereas cholesterol and apolipoprotein A2 were decreased. Moreover, a similarly perturbed profile was apparent when compared with other patients with cardiogenic shock who are in the intensive care unit when looking at a 1-week time course, highlighting close links between COVID-19 and lipid metabolism. The metabolic profile of COVID-19 patients distinguishes those from healthy controls and also from patients with cardiogenic shock. In contrast, anti-SARS-CoV-2 antibody-positive individuals without acute COVID-19 did not show a significantly perturbed metabolic profile compared with age- and sex-matched healthy controls, but SARS-CoV-2 antibody-titers correlated significantly with metabolic parameters, including levels of glycine, ApoA2, and small-sized low- and high-density lipoprotein subfractions. Our data suggest that COVID-19 is associated with dyslipidemia, which is not observed in anti-SARS-CoV-2 antibody-positive individuals who have not developed severe courses of the disease. This suggests that lipoprotein profiles may represent a confounding risk factor for COVID-19 with potential for patient stratification.
Author Ragab, Mohab
Eitel, Ingo
Ehlers, Marc
Meyer-Saraei, Roza
Lixenfeld, Anne Sophie
Martin, Emily
Graf, Tobias
Sina, Christian
Lehrian, Selina
Künsting, Inga
Käding, Nadja
von Kopylow, Vera
Föh, Bandik
Taube, Stefan
Kreutzmann, Fabian
Mallagaray, Alvaro
Rahmöller, Johann
Günther, Ulrich L.
Schmelter, Franziska
Jantzen, Eckard
AuthorAffiliation 2 Research and Development Department, GALAB Laboratories GmbH, Hamburg , Germany
3 Medical Department I, University Hospital Schleswig-Holstein, Lübeck , Germany
9 Department of Infectious Diseases and Microbiology, University of Lübeck, Lübeck , Germany
8 Institute of Virology and Cell Biology, University of Lübeck, Lübeck , Germany
1 Institute of Nutritional Medicine, University of Lübeck, Lübeck , Germany
6 Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Center Lübeck, Lübeck , Germany
5 Department of Anesthesiology and Intensive Care, University Medical Center Schleswig-Holstein, Lübeck , Germany
7 German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Lübeck , Germany
4 Institute of Chemistry and Metabolomics, University of Lübeck, Lübeck , Germany
AuthorAffiliation_xml – name: 1 Institute of Nutritional Medicine, University of Lübeck, Lübeck , Germany
– name: 6 Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Center Lübeck, Lübeck , Germany
– name: 3 Medical Department I, University Hospital Schleswig-Holstein, Lübeck , Germany
– name: 5 Department of Anesthesiology and Intensive Care, University Medical Center Schleswig-Holstein, Lübeck , Germany
– name: 9 Department of Infectious Diseases and Microbiology, University of Lübeck, Lübeck , Germany
– name: 4 Institute of Chemistry and Metabolomics, University of Lübeck, Lübeck , Germany
– name: 7 German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Lübeck , Germany
– name: 2 Research and Development Department, GALAB Laboratories GmbH, Hamburg , Germany
– name: 8 Institute of Virology and Cell Biology, University of Lübeck, Lübeck , Germany
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ContentType Journal Article
Copyright Copyright © 2021 Schmelter, Föh, Mallagaray, Rahmöller, Ehlers, Lehrian, von Kopylow, Künsting, Lixenfeld, Martin, Ragab, Meyer-Saraei, Kreutzmann, Eitel, Taube, Käding, Jantzen, Graf, Sina and Günther.
Copyright © 2021 Schmelter, Föh, Mallagaray, Rahmöller, Ehlers, Lehrian, von Kopylow, Künsting, Lixenfeld, Martin, Ragab, Meyer-Saraei, Kreutzmann, Eitel, Taube, Käding, Jantzen, Graf, Sina and Günther. 2021 Schmelter, Föh, Mallagaray, Rahmöller, Ehlers, Lehrian, von Kopylow, Künsting, Lixenfeld, Martin, Ragab, Meyer-Saraei, Kreutzmann, Eitel, Taube, Käding, Jantzen, Graf, Sina and Günther
Copyright_xml – notice: Copyright © 2021 Schmelter, Föh, Mallagaray, Rahmöller, Ehlers, Lehrian, von Kopylow, Künsting, Lixenfeld, Martin, Ragab, Meyer-Saraei, Kreutzmann, Eitel, Taube, Käding, Jantzen, Graf, Sina and Günther.
– notice: Copyright © 2021 Schmelter, Föh, Mallagaray, Rahmöller, Ehlers, Lehrian, von Kopylow, Künsting, Lixenfeld, Martin, Ragab, Meyer-Saraei, Kreutzmann, Eitel, Taube, Käding, Jantzen, Graf, Sina and Günther. 2021 Schmelter, Föh, Mallagaray, Rahmöller, Ehlers, Lehrian, von Kopylow, Künsting, Lixenfeld, Martin, Ragab, Meyer-Saraei, Kreutzmann, Eitel, Taube, Käding, Jantzen, Graf, Sina and Günther
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Keywords COVID-19
NMR
SARS-CoV-2
metabolomics
lipoproteins
Language English
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Reviewed by: Sander Kooijman, Leiden University Medical Center, Netherlands
Toby James Athersuch, Imperial College London, United Kingdom
These authors have contributed equally to this work and share senior authorship
These authors have contributed equally to this work and share first authorship
This article was submitted to Metabolomics, a section of the journal Frontiers in Molecular Biosciences
Edited by: Emmanuel Mikros, National and Kapodistrian University of Athens, Greece
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Snippet Coronavirus disease 2019 (COVID-19) is a viral infection affecting multiple organ systems of great significance for metabolic processes. Thus, there is...
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SubjectTerms COVID-19
lipoproteins
metabolomics
Molecular Biosciences
NMR
SARS-CoV-2
Title Metabolic and Lipidomic Markers Differentiate COVID-19 From Non-Hospitalized and Other Intensive Care Patients
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