Metabolomics Study Of Serum And Urine In Patients With COVID-19 During Rehabilitation

Background:Metabolism is critical for sustaining life,immunity and infection,but its role in patients who recovered from Coronavirus disease 2019（COVID-19）is unclear.This study was aimed to characterize differential metabolites in the urine and sera of patients who recovered from COVID-19 against uninfected individuals,to uncover the metabolome of patients who recovered from COVID-19.Methods:Urine and sera were collected from13 patients within 10 days of discharge from the Changchun Infectious Disease Hospital,a COVID-19 treatment facility and 13uninfected healthy individuals.Ultra-high-performance liquid chromatography coupled with quadrupole orbitrap mass spectrometry（UPLC-Q-Orbitrap-MS）and proton nuclear magnetic resonance spectroscopy（~1H-NMR）were applied t compared the difference of urine and serum metabolites between patients who recovered from COVID-19 and uninfected healthy individuals.KEGG enrichment analysis identified significantly enriched metabolic pathways.Finally,the Spearman correlation coefficients determined the correlation between differential metabolites and clinical laboratory results.Results:There were 90 differential metabolites（~1H-NMR:16;UPLC-Q-Orbitrap-MS:74）in urine and 53 differential metabolites（~1H-NMR:16;UPLC-Q-Orbitrap-MS:35）in the sera of patients who recovered from COVID-19 contrary to uninfected healthy individuals.Ketone body metabolism was most significantly enriched in the urine and serum of recovered patients from COVID-19.Acetoacetate,acetone,succinate,and glutamine are the potential biomarkers of patients who recovered from COVID-19.Conclusions:These findings combine the complementary information from urine and sera detected by UPLC-Q-Orbitrap-MS and ~1H-NMR,and may provide a reference for monitoring the prognosis of patients discharged and recovering from COVID-19.