Incomplete Systemic Recovery and Metabolic Phenoreversion in Post-Acute-Phase Nonhospitalized COVID-19 Patients: Implications for Assessment of Post-Acute COVID-19 Syndrome.
Elaine Holmes,Elaine Holmes,Julien Wist,Julien Wist,Reika Masuda,Samantha Lodge,Philipp Nitschke,Torben Kimhofer,Ruey Leng Loo,Sofina Begum,Berin A. Boughton,Rongchang Yang,Aude-Claire Morillon,Sung Tong Chin,Drew Hall,Monique Ryan,Sze-How Bong,Dale W. Edgar,Dale W. Edgar,John C. Lindon,Toby Richards,Bu B. Yeap,Sven Pettersson,Sven Pettersson,Manfred Spraul,Hartmut Schaefer,Nathan G. Lawler,Nicola Gray,Luke Whiley,Jeremy K. Nicholson,Jeremy K. Nicholson +30 more
TLDR
In this paper, a multivariate metabotyping approach was used to assess the functional recovery of non-hospitalized COVID-19 patients and the possible biochemical sequelae of "Post-Acute CoV-19 Syndrome", colloquially known as long-COVID.Abstract:
We present a multivariate metabotyping approach to assess the functional recovery of nonhospitalized COVID-19 patients and the possible biochemical sequelae of "Post-Acute COVID-19 Syndrome", colloquially known as long-COVID. Blood samples were taken from patients ca. 3 months after acute COVID-19 infection with further assessment of symptoms at 6 months. Some 57% of the patients had one or more persistent symptoms including respiratory-related symptoms like cough, dyspnea, and rhinorrhea or other nonrespiratory symptoms including chronic fatigue, anosmia, myalgia, or joint pain. Plasma samples were quantitatively analyzed for lipoproteins, glycoproteins, amino acids, biogenic amines, and tryptophan pathway intermediates using Nuclear Magnetic Resonance (NMR) spectroscopy and mass spectrometry. Metabolic data for the follow-up patients (n = 27) were compared with controls (n = 41) and hospitalized severe acute respiratory syndrome SARS-CoV-2 positive patients (n = 18, with multiple time-points). Univariate and multivariate statistics revealed variable patterns of functional recovery with many patients exhibiting residual COVID-19 biomarker signatures. Several parameters were persistently perturbed, e.g., elevated taurine (p = 3.6 × 10-3 versus controls) and reduced glutamine/glutamate ratio (p = 6.95 × 10-8 versus controls), indicative of possible liver and muscle damage and a high energy demand linked to more generalized tissue repair or immune function. Some parameters showed near-complete normalization, e.g., the plasma apolipoprotein B100/A1 ratio was similar to that of healthy controls but significantly lower (p = 4.2 × 10-3) than post-acute COVID-19 patients, reflecting partial reversion of the metabolic phenotype (phenoreversion) toward the healthy metabolic state. Plasma neopterin was normalized in all follow-up patients, indicative of a reduction in the adaptive immune activity that has been previously detected in active SARS-CoV-2 infection. Other systemic inflammatory biomarkers such as GlycA and the kynurenine/tryptophan ratio remained elevated in some, but not all, patients. Correlation analysis, principal component analysis (PCA), and orthogonal-partial least-squares discriminant analysis (O-PLS-DA) showed that the follow-up patients were, as a group, metabolically distinct from controls and partially comapped with the acute-phase patients. Significant systematic metabolic differences between asymptomatic and symptomatic follow-up patients were also observed for multiple metabolites. The overall metabolic variance of the symptomatic patients was significantly greater than that of nonsymptomatic patients for multiple parameters (χ2 p = 0.014). Thus, asymptomatic follow-up patients including those with post-acute COVID-19 Syndrome displayed a spectrum of multiple persistent biochemical pathophysiology, suggesting that the metabolic phenotyping approach may be deployed for multisystem functional assessment of individual post-acute COVID-19 patients.read more
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Long COVID: major findings, mechanisms and recommendations
TL;DR: Davis, McCorkell, Vogel and Topol as discussed by the authors explore the current literature and highlight key findings, the overlap with other conditions, the variable onset of symptoms, long COVID in children and the impact of vaccinations.
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Post-COVID-19 syndrome, low-grade inflammation and inflammatory markers: a cross-sectional study
M. Maamar,A. Artime,Emilio Pariente,P. Fierro,Yolanda Ruiz,Silvia Gutiérrez,María-Cres Tobalina,S. Díaz-Salazar,Carmen Ramos,José M. Olmos,José L. Hernández +10 more
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Covid-19 and Liver Injury: Role of Inflammatory Endotheliopathy, Platelet Dysfunction, and Thrombosis.
TL;DR: In this article, vascular inflammation and thrombosis were presented as a potential mechanism of liver injury and liver-related complications in coronavirus disease 2019 (COVID-19) symptoms caused by SARS-CoV-2.
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Long-term side effects and lingering symptoms post COVID-19 recovery.
Mohammad Zarei,Mohammad Zarei,Deepanwita Bose,Masoud Nouri-Vaskeh,Masoud Nouri-Vaskeh,Vida Tajiknia,Ramin Zand,Mehdi Ghasemi +7 more
TL;DR: In this paper, the authors review the long-term impact of COVID-19 on different organ systems reported from different clinical studies and provide patients with previous SARS-CoV-2 infection with expectations of longterm effects during or after recovery.
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Uneven metabolic and lipidomic profiles in recovered COVID-19 patients as investigated by plasma NMR metabolomics.
Maider Bizkarguenaga,Chiara Bruzzone,Rubén Gil-Redondo,Itxaso SanJuan,Itziar Martín-Ruiz,Diego Barriales,Ainhoa Palacios,Samuel T Pasco,Beatriz González-Valle,Ana Laín,Lara Herrera,Aida Azkarate,Miguel Angel Vesga,Cristina Eguizabal,Juan Anguita,Nieves Embade,José M. Mato,Oscar Millet +17 more
TL;DR: In this article, the authors used NMR metabolomics to characterize plasma samples from a cohort of the abovementioned group of COVID-19 patients (n = 69), between 3 and 10 months after diagnosis, and compared them with a set of reference samples from individuals never infected by the virus.
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