Association between Circulating Amino Acids and COVID-19 Severity

Ina Maltais-Payette; Fannie Lajeunesse-Trempe; Philippe Pibarot; Laurent Biertho; André Tchernof

doi:10.3390/metabo13020201

Association between Circulating Amino Acids and COVID-19 Severity

Metabolites. 2023 Jan 29;13(2):201. doi: 10.3390/metabo13020201.

Authors

Ina Maltais-Payette^{1

2}, Fannie Lajeunesse-Trempe^{1

2}, Philippe Pibarot^{1

3}, Laurent Biertho^{1

4}, André Tchernof^{1

2}

Affiliations

¹ Quebec Heart and Lung Institute, Quebec City, QC G1V 4G5, Canada.
² School of Nutrition, Faculty of Agriculture and Food Sciences, Laval University, Quebec City, QC G1V 0A6, Canada.
³ Department of Medicine, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada.
⁴ Department of Surgery, Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada.

Abstract

The severity of the symptoms associated with COVID-19 is highly variable, and has been associated with circulating amino acids as a group of analytes in metabolomic studies. However, for each individual amino acid, there are discordant results among studies. The aims of the present study were: (i) to investigate the association between COVID-19-symptom severity and circulating amino-acid concentrations; and (ii) to assess the ability of circulating amino-acid levels to predict adverse outcomes (intensive-care-unit admission or hospital death). We studied a sample of 736 participants from the Biobanque Québécoise COVID-19. All participants tested positive for COVID-19, and the severity of symptoms was determined using the World-Health-Organization criteria. Circulating amino acids were measured by HPLC-MS/MS. We used logistic models to assess the association between circulating amino acids concentrations and the odds of presenting mild vs. severe or mild vs. moderate symptoms, as well as their accuracy in predicting adverse outcomes. Patients with severe COVID-19 symptoms were older on average, and they had a higher prevalence of obesity and type 2 diabetes. Out of 20 amino acids tested, 16 were significantly associated with disease severity, with phenylalanine (positively) and cysteine (inversely) showing the strongest associations. These associations remained significant after adjustment for age, sex and body mass index. Phenylalanine had a fair ability to predict the occurrence of adverse outcomes, similar to traditionally measured laboratory variables. A multivariate model including both circulating amino acids and clinical variables had a 90% accuracy at predicting adverse outcomes in this sample. In conclusion, patients presenting severe COVID-19 symptoms have an altered amino-acid profile, compared to those with mild or moderate symptoms.

Keywords: BQC19; COVID-19; amino acids; obesity.

Grants and funding

The Biobanque Québécoise COVID-19 is funded by the Fonds de recherche du Québec—Santé, Génome Québec and the Publich Health Agency of Canada. This study was funded by a research grant form the Foundation of Institut universitaire de cardiologie et de pneumologie de Québec—Université Laval to A.T., L.B. and P.B. I.M.-P. is the recipient of a scholarship from the Canadian Institutes of Health Research. L.B. and A.T. are co-directors of the Research Chair in Bariatric and Metabolic Surgery at Laval University.