Metabolomics in the Diagnosis and Prognosis of COVID-19.

Mohammad Rubayet Hasan,Mohammed Suleiman,Andrés Pérez-López

doi:10.3389/fgene.2021.721556

Mohammad Rubayet Hasan, Mohammed Suleiman + Show 1 more

Open Access

https://doi.org/10.3389/fgene.2021.721556

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Abstract

Coronavirus disease 2019 (COVID-19) pandemic triggered an unprecedented global effort in developing rapid and inexpensive diagnostic and prognostic tools. Since the genome of SARS-CoV-2 was uncovered, detection of viral RNA by RT-qPCR has played the most significant role in preventing the spread of the virus through early detection and tracing of suspected COVID-19 cases and through screening of at-risk population. However, a large number of alternative test methods based on SARS-CoV-2 RNA or proteins or host factors associated with SARS-CoV-2 infection have been developed and evaluated. The application of metabolomics in infectious disease diagnostics is an evolving area of science that was boosted by the urgency of COVID-19 pandemic. Metabolomics approaches that rely on the analysis of volatile organic compounds exhaled by COVID-19 patients hold promise for applications in a large-scale screening of population in point-of-care (POC) setting. On the other hand, successful application of mass-spectrometry to detect specific spectral signatures associated with COVID-19 in nasopharyngeal swab specimens may significantly save the cost and turnaround time of COVID-19 testing in the diagnostic microbiology and virology laboratories. Active research is also ongoing on the discovery of potential metabolomics-based prognostic markers for the disease that can be applied to serum or plasma specimens. Several metabolic pathways related to amino acid, lipid and energy metabolism were found to be affected by severe disease with COVID-19. In particular, tryptophan metabolism via the kynurenine pathway were persistently dysregulated in several independent studies, suggesting the roles of several metabolites of this pathway such as tryptophan, kynurenine and 3-hydroxykynurenine as potential prognostic markers of the disease. However, standardization of the test methods and large-scale clinical validation are necessary before these tests can be applied in a clinical setting. With rapidly expanding data on the metabolic profiles of COVID-19 patients with varying degrees of severity, it is likely that metabolomics will play an important role in near future in predicting the outcome of the disease with a greater degree of certainty.

Highlights

The ongoing pandemic of coronavirus disease 2019 (COVID-19) has created massive disruptions and loss of human lives around the world
This is important in the context that the severity of COVID-19 disease is linked to host inflammatory process, which may be related to alterations in cellular metabolic processes
In a recent immunometabolic study, strong association was seen between proinflammatory cytokines and chemokines, such as IL6, M-cerebrospinal fluid (CSF), IL-1α, and IL-1β with metabolites involved in amino acid metabolism, nicotinamide adenine dinucleotide (NAD)+ metabolism, purine and pyrimidine metabolism, TCA cycle, and primary bile acid metabolism in severe COVID-19 patients (Xiao et al, 2021)

Summary

Introduction

The ongoing pandemic of coronavirus disease 2019 (COVID-19) has created massive disruptions and loss of human lives around the world. In an interesting proof of concept study, metabolomic analytic approaches were applied to discriminate between COVID-19 acute respiratory distress syndrome (ARDS) and non-COVID-19 ARDS cases based on VOCs in their exhaled air (Grassin-Delyle et al, 2021). Metabolite data in relation to COVID-19 diagnosis were limited, a number of studies have been published during the past year on the MS based detection of SARS-CoV-2 offering potential alternatives to molecular tests.

Results

Conclusion