Multiplatform Metabolomics:\nEnhancing the Severity\nRisk Prognosis of SARS-CoV‑2 Infection

Concerns about the SARS-CoV-2 outbreak (COVID-19) continue\nto persist\neven years later, with the emergence of new variants and the risk\nof disease severity. Common clinical symptoms, like cough, fever,\nand respiratory symptoms, characterize the noncritical patients, classifying\nthem from mild to moderate. In a more severe and complex scenario,\nthe virus infection can affect vital organs, resulting, for instance,\nin pneumonia and impaired kidney and heart function. However, it is\nwell-known that subclinical symptoms at a metabolic level can be observed\npreviously but require a proper diagnosis because viral replication\non the host leaves a track with a different profile depending on the\nseverity of the illness. Metabolomic profiles of mild, moderate, and\nsevere COVID-19 patients were obtained by multiple platforms (LC-HRMS\nand MALDI-MS), increasing the chance to elucidate a prognosis for\nseverity risk. A strong link was discovered between phenylalanine\nmetabolism and increased COVID-19 severity symptoms, a pathway linked\nto cardiac and neurological consequences. Glycerophospholipids and\nsphingolipid metabolisms were also dysregulated linearly with the\nincreasing symptom severity, which can be related to virus proliferation,\nimmune system avoidance, and apoptosis escaping. Our data, endorsed\nby other literature, strengthens the notion that these pathways might\nplay a vital role in a patient’s prognosis.