By Oscar Millet

Coronavirus disease (COVID‐19) is a systemic infection that exerts significant impact on the metabolism. It is also clear that SARS-CoV2 infection is a systemic disease that drastically alters the metabolism of the host. Using NMR spectroscopy, we have investigated the natural history of the disease, based on metabolomic analyses. To that end, the metabolomic and lipidomic serum profile was complemented with novel NMR-based analytical procedures to quantify biomarkers of inflammation and atherosclerotic risk. We applied this methodology to a set of about 1,200 samples including hospitalized patients, COVID-19 onset (n=405) and 3-6 days post-infection (n=182), the follow up of discharged COVID-19 patients: 1-2 months post-infection (n=135), 3-6 months post-infection (n= 353), and unrelated patients diagnosed with long COVID (n = 105). These samples were compared to healthy individuals that did not suffer the disease (n=750). We found that COVID-19 has implications on several metabolites and mainly on lipoproteins concentrations. Small dense LDL, as seen as atherogenic molecules, are elevated in serum during SARS-Co-V2 infection with some of their subfractions remaining elevated after recovery. In turn, a particular pathogenic metabolic signature is maintained after 1-2 months after infection to be gradually transformed into a normal metabolic profile from 3-months on. That said, long COVID patients seem to retain a specific metabolic and lipoprotein altered profile, that agrees well with cytokine/chemokine analysis.

Session #3: Metabolomics/Mixture analysis: to isolate or not to isolate … lets go with not!