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RBC metabolomics in COVID patients


In a collaboration with the Fundación de Investigación del Hospital General (FIHGUV) MolDrug has performed a comprehensive metabolomics study of red blood cells (RBCs) of COVID patients with moderate and severe disease evolution in hospital. Patients were stratified into moderate or severe outcomes (acute respiratory failure, acute myocardial injury, acute kidney failure, ICU admission or death). We analyzed the metabolic profile of RBCs using Nuclear Magnetic Resonance spectroscopy. The resulting profiles were then compared, performing multivariate PLS-DA analysis between groups.

As a result, we were able to identify several metabolites that were specifically altered in patients with a more severe outcome, proving an affection of the glutathione redox system and the pentose phosphate pathway in these patients. Also, specific biomarkers for diabetic patients and patients with a lethal disease outcome could be identified. Furthermore, two subgroups of severe patients were identified, based on their RBC profile, one with higher myocardial damage, disseminated coagulation, acidosis and a lower survival rate. In these patients, the Luebering–Rapoport pathway that regulates oxygen release from hemoglobin and delivery to tissues seemed to be altered, as well as glycolysis. When analyzing the evolution of metabolite levels over time, some of the identified metabolites show an opposite tendency between a negative and a positive evolution, including 2,3-BPG, glutathione, NADP, glutamate, valine and creatine.