Int J Mol Sci. 2020 Nov 16. pii: E8623. [Epub ahead of print]21(22):
Elettra Barberis,
Sara Timo,
Elia Amede,
Virginia V Vanella,
Chiara Puricelli,
Giuseppe Cappellano,
Davide Raineri,
Micol G Cittone,
Eleonora Rizzi,
Anita R Pedrinelli,
Veronica Vassia,
Francesco G Casciaro,
Simona Priora,
Ilaria Nerici,
Alessandra Galbiati,
Eyal Hayden,
Marco Falasca,
Rosanna Vaschetto,
Pier Paolo Sainaghi,
Umberto Dianzani,
Roberta Rolla,
Annalisa Chiocchetti,
Gianluca Baldanzi,
Emilio Marengo,
Marcello Manfredi.
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread to nearly every continent, registering over 1,250,000 deaths worldwide. The effects of SARS-CoV-2 on host targets remains largely limited, hampering our understanding of Coronavirus Disease 2019 (COVID-19) pathogenesis and the development of therapeutic strategies. The present study used a comprehensive untargeted metabolomic and lipidomic approach to capture the host response to SARS-CoV-2 infection. We found that several circulating lipids acted as potential biomarkers, such as phosphatidylcholine 14:0_22:6 (area under the curve (AUC) = 0.96), phosphatidylcholine 16:1_22:6 (AUC = 0.97), and phosphatidylethanolamine 18:1_20:4 (AUC = 0.94). Furthermore, triglycerides and free fatty acids, especially arachidonic acid (AUC = 0.99) and oleic acid (AUC = 0.98), were well correlated to the severity of the disease. An untargeted analysis of non-critical COVID-19 patients identified a strong alteration of lipids and a perturbation of phenylalanine, tyrosine and tryptophan biosynthesis, phenylalanine metabolism, aminoacyl-tRNA degradation, arachidonic acid metabolism, and the tricarboxylic acid (TCA) cycle. The severity of the disease was characterized by the activation of gluconeogenesis and the metabolism of porphyrins, which play a crucial role in the progress of the infection. In addition, our study provided further evidence for considering phospholipase A2 (PLA2) activity as a potential key factor in the pathogenesis of COVID-19 and a possible therapeutic target. To date, the present study provides the largest untargeted metabolomics and lipidomics analysis of plasma from COVID-19 patients and control groups, identifying new mechanisms associated with the host response to COVID-19, potential plasma biomarkers, and therapeutic targets.
Keywords: SARS-CoV-2; biomarkers; fatty acids; metabolism