Metabolomic/lipidomic profiling of COVID-19 and individual response to tocilizumab

PLoS Pathog. 2021 Feb 1;17(2):e1009243. doi: 10.1371/journal.ppat.1009243. eCollection 2021 Feb.

Abstract

The current pandemic emergence of novel coronavirus disease (COVID-19) poses a relevant threat to global health. SARS-CoV-2 infection is characterized by a wide range of clinical manifestations, ranging from absence of symptoms to severe forms that need intensive care treatment. Here, plasma-EDTA samples of 30 patients compared with age- and sex-matched controls were analyzed via untargeted nuclear magnetic resonance (NMR)-based metabolomics and lipidomics. With the same approach, the effect of tocilizumab administration was evaluated in a subset of patients. Despite the heterogeneity of the clinical symptoms, COVID-19 patients are characterized by common plasma metabolomic and lipidomic signatures (91.7% and 87.5% accuracy, respectively, when compared to controls). Tocilizumab treatment resulted in at least partial reversion of the metabolic alterations due to SARS-CoV-2 infection. In conclusion, NMR-based metabolomic and lipidomic profiling provides novel insights into the pathophysiological mechanism of human response to SARS-CoV-2 infection and to monitor treatment outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • COVID-19 / blood
  • COVID-19 / epidemiology
  • COVID-19 Drug Treatment*
  • Female
  • Humans
  • Lipidomics*
  • Lipids / blood*
  • Male
  • Nuclear Magnetic Resonance, Biomolecular
  • SARS-CoV-2 / metabolism*

Substances

  • Antibodies, Monoclonal, Humanized
  • Lipids
  • tocilizumab

Grants and funding

AV and VG are supported by an AIRC fellowship for Italy. This study was supported by funds from the Department of Experimental and Clinical Medicine of University of Florence, "Excellence Departments 2018–2022 Project". The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.