Pasteur effect in leukocyte energy metabolism of patients with mild, moderate, and severe COVID-19

Abstract Objectives The Pasteur effect in cellular energy metabolism is defined as the switch to anaerobic glycolysis due to alterations in ambient oxygen concentration or inhibition of the electron transport chain (ETC) and oxidative phosphorylation. This study aimed to determine the effect of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection on the energy metabolism of leukocytes among Coronavirus Disease 2019 (COVID-19) patients at various stages. Methods A total of 90 cases were analyzed in asymptomatic, mild, moderate, and severe COVID-19 patients. Levels of aerobic glycolysis intermediates and products of anaerobic glycolysis were measured in leukocytes with liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. Results A decrease in the rate of aerobic glycolysis was found as the disease progressed (p-values<0.001), while the anaerobic glycolysis rate was unchanged in all study groups because lactate levels had no difference between asymptomatic, mild, moderate, and severe groups (p=0.754). Moreover, the ratios of lactate to Tricarboxylic Acid (TCA) cycle parameters demonstrated a significant reduction in the rate of aerobic glycolysis of COVID-19 patients at different stages (p-values<0.001). Furthermore, Receiver Operating Characteristic (ROC) curve analysis for citrate, alpha-ketoglutarate, fumarate, lactate, lactate/citrate, lactate/alpha-ketoglutarate, and lactate/fumarate had significant cut-off values in Moderate and Severe patients (p<0.001). Conclusions Our results suggest that the Pasteur effect from aerobic to anaerobic glycolysis was shown to be induced as the severity of COVID-19 progresses.