Abstract
Severe acute respiratory syndrome-coronavirus (SARS-CoV) and SARS-like coronavirus are a potential threat to global health. However, reviews of the long-term effects of clinical treatments in SARS patients are lacking. Here a total of 25 recovered SARS patients were recruited 12 years after infection. Clinical questionnaire responses and examination findings indicated that the patients had experienced various diseases, including lung susceptibility to infections, tumors, cardiovascular disorders, and abnormal glucose metabolism. As compared to healthy controls, metabolomic analyses identified significant differences in the serum metabolomes of SARS survivors. The most significant metabolic disruptions were the comprehensive increase of phosphatidylinositol and lysophospha tidylinositol levels in recovered SARS patients, which coincided with the effect of methylprednisolone administration investigated further in the steroid treated non-SARS patients with severe pneumonia. These results suggested that high-dose pulses of methylprednisolone might cause long-term systemic damage associated with serum metabolic alterations. The present study provided information for an improved understanding of coronavirus-associated pathologies, which might permit further optimization of clinical treatments.
Highlights
Between 2002 and 2003, severe acute respiratory syndrome (SARS) caused by coronavirus (SARS-CoV) affected over 30 countries on five continents
It was observed that the recovered SARS patients were affected by various serum metabolic disorders predominantly associated with lipid metabolism, including hyperlipidemia (HL), cardiovascular abnormality (CVA), and abnormal glucose metabolism (AGM)
During SARS-CoV infection, these patients had been treated with methylprednisolone at an average of 5,454 mg for a mean period of 36 days, with a maximum daily dose of 381 mg (Table 1)
Summary
Between 2002 and 2003, severe acute respiratory syndrome (SARS) caused by coronavirus (SARS-CoV) affected over 30 countries on five continents. Clinical treatments implemented following the sudden outbreak of SARS-CoV included empirical and experimental types, their effectiveness and side effects remain controversial. Antiviral drugs, including ribavirin, lopinavir, and ritonavir, were prescribed soon after SARS-CoV was identified as the causative agent[7, 8]. Metabolites, including phosphatidylinositol (PI) and lysophosphatidylinositol (LPI), are associated with cellular entry and/or egress of respiratory viruses[17, 18]. It remains unknown whether or not serum levels of PI and LPI are disregulated during recovery of SARS infections. It was observed that the recovered SARS patients were affected by various serum metabolic disorders predominantly associated with lipid metabolism, including hyperlipidemia (HL), cardiovascular abnormality (CVA), and abnormal glucose metabolism (AGM)
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