Using a targeted metabolomics approach to explore differences in ARDS associated with COVID-19 compared to ARDS caused by H1N1 influenza and bacterial pneumonia.
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Lee Chel Hee, Banoei Mohammad M, Ansari Mariam, Cheng Matthew P, Lamontagne Francois, Griesdale Donald, Lasry David E, Demir Koray, Dhingra Vinay, Tran Karen C, Lee Terry, Burns Kevin, Sweet David, Marshall John, Slutsky Arthur, Murthy Srinivas, Singer Joel, Patrick David M, Lee Todd C, Boyd John H, Walley Keith R, Fowler Robert, Haljan Greg, Vinh Donald C, Mcgeer Alison, Maslove David, Mann Puneet, Donohoe Kathryn, Hernandez Geraldine, Rocheleau Genevieve, Trahtemberg Uriel, Kumar Anand, Lou Ma, Dos Santos Claudia, Baker Andrew, Russell James A, Winston Brent W, *ARBs CORONA I. Investigators
Аннотация
OBJECTIVE: To map and compare metabolic phenotypes of different infectious causes of ARDS to better understand the metabolic pathways involved in the underlying pathogenesis.
METHODS: We analyzed metabolic phenotypes of 3 ARDS cohorts caused by COVID-19, H1N1 influenza, and bacterial pneumonia compared to non-ARDS COVID-19-infected patients and ICU-ventilated controls. Targeted metabolomics was performed on plasma samples from a total of 150 patients using quantitative LC-MS/MS and DI-MS/MS analytical platforms.
RESULTS: Distinct metabolic phenotypes were detected between different infectious causes of ARDS. There were metabolomics differences between ARDSs associated with COVID-19 and H1N1, which include metabolic pathways involving taurine and hypotaurine, pyruvate, TCA cycle metabolites, lysine, and glycerophospholipids. ARDSs associated with bacterial pneumonia and COVID-19 differed in the metabolism of D-glutamine and D-glutamate, arginine, proline, histidine, and pyruvate. The metabolic profile of COVID-19 ARDS (C19/A) patients admitted to the ICU differed from COVID-19 pneumonia (C19/P) patients who were not admitted to the ICU in metabolisms of phenylalanine, tryptophan, lysine, and tyrosine. Metabolomics analysis revealed significant differences between C19/A, H1N1/A, and PNA/A vs ICU-ventilated controls, reflecting potentially different disease mechanisms.
CONCLUSION: Different metabolic phenotypes characterize ARDS associated with different viral and bacterial infections.