Metabolic Signatures of Type 2 Diabetes Mellitus and Hypertension in COVID-19 Patients With Different Disease Severity

Mohamed A Elrayess; Farhan S Cyprian; Abdallah M Abdallah; Mohamed M Emara; Ilhame Diboun; Najeha Anwardeen; Sven Schuchardt; Hadi M Yassine

doi:10.3389/fmed.2021.788687

Metabolic Signatures of Type 2 Diabetes Mellitus and Hypertension in COVID-19 Patients With Different Disease Severity

Front Med (Lausanne). 2022 Jan 10:8:788687. doi: 10.3389/fmed.2021.788687. eCollection 2021.

Authors

Mohamed A Elrayess¹, Farhan S Cyprian², Abdallah M Abdallah^{2

3}, Mohamed M Emara^{2

3}, Ilhame Diboun⁴, Najeha Anwardeen¹, Sven Schuchardt⁵, Hadi M Yassine^{1

6}

Affiliations

¹ Biomedical Research Center (BRC), Qatar University, Doha, Qatar.
² Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar.
³ Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University, Doha, Qatar.
⁴ College of Health and Life Sciences, Hamad Bin Khalifa University (HBKU), Doha, Qatar.
⁵ Department of Bio- and Environmental Analytics, Fraunhofer Institute for Toxicology and Experimental Medicine (ITEM), Hannover, Germany.
⁶ College of Health Sciences, Qatar University, Doha, Qatar.

Abstract

Introduction: Increased COVID-19 disease severity is higher among patients with type 2 diabetes mellitus and hypertension. However, the metabolic pathways underlying this association are not fully characterized. This study aims to identify the metabolic signature associated with increased COVID-19 severity in patients with diabetes mellitus and hypertension. Methods: One hundred and fifteen COVID-19 patients were divided based on disease severity, diabetes status, and hypertension status. Targeted metabolomics of serum samples from all patients was performed using tandem mass spectrometry followed by multivariate and univariate models. Results: Reduced levels of various triacylglycerols were observed with increased disease severity in the diabetic patients, including those containing palmitic (C16:0), docosapentaenoic (C22:5, DPA), and docosahexaenoic (C22:6, DHA) acids (FDR < 0.01). Functional enrichment analysis revealed triacylglycerols as the pathway exhibiting the most significant changes in severe COVID-19 in diabetic patients (FDR = 7.1 × 10^-27). Similarly, reduced levels of various triacylglycerols were also observed in hypertensive patients corresponding with increased disease severity, including those containing palmitic, oleic (C18:1), and docosahexaenoic acids. Functional enrichment analysis revealed long-chain polyunsaturated fatty acids (n-3 and n-6) as the pathway exhibiting the most significant changes with increased disease severity in hypertensive patients (FDR = 0.07). Conclusions: Reduced levels of triacylglycerols containing specific long-chain unsaturated, monounsaturated, and polyunsaturated fatty acids are associated with increased COVID-19 severity in diabetic and hypertensive patients, offering potential novel diagnostic and therapeutic targets.

Keywords: COVID-19; diabetes mellitus; docosahexaenoic acid; docosapentaenoic acid; hypertension; oleic acid; palmitic acid; triacylglycerols.