Exploratory comparison of PASC and SARS-CoV-2 infection through metabolomics and lipidomics in early pandemic and Omicron-era

While symptomology of post-acute sequelae of COVID-19 (PASC) is well-known, and more risk factors are being identified, the physiological mechanisms of this condition remain largely undetermined. In the early pandemic into the pre-Omicron era, plasma samples were obtained from SARS-CoV-2 positive patients admitted to the hospital or in the emergency department at a single timepoint. The 68 convenience samples were analyzed using metabolomics and lipidomics to identify any signatures associated with development of PASC. After correction for false discovery rate, no metabolomic features distinguished the 24% of patients that developed PASC from those who did not. Glycerophospholipids, including PI(20:4_18:0), and triglycerides, which are known to be involved in energy metabolism and immune responses, differed in abundance in PASC compared to non-PASC patients. A small sample size, batch effects, and inaccessible clinical data resulted in an exploratory analysis with moderate effects in this convenience sample. Discerning biological pathways in SARS-CoV-2 infection, PASC, and their linkage may help elucidate causes and uncover preventative and treatment approaches for patients with PASC.