Inflammatory And Plasma Metabolomic Profiles In Recovered COVID-19 Patients 3 Months After Discharge

Part ? Inflammatory Profiles and Clinical Features in Recovered COVID-19 3 Months After DischargePurpose: A considerable number of COVID-19 survivors have recovered from the virus infection,and the sequelae still require continuous follow-up.However,most of the reported researches focused specifically on the mortality of COVID-19.Post-discharge immunity and its correlation with clinical features among patients recovered from COVID-19 are poorly described.This prospective cross-sectional study explored the inflammatory profiles and clinical recovery of COVID-19 patients at 3 months post-discharge.Methods: COVID-19 patients discharged from four hospitals in Wuhan,recovered asymptomatic patients(RAPs)from an isolation hotel,and uninfected healthy controls(HC)were recruited.The 72 age-,sex-and body mass index-matched participants included 19 recovered severe/critical patients(RSPs),20 recovered mild/moderate patients(RMPs),16 RAPs,and 17 HC.Viral nucleic acid and antibody detection,laboratory examination,computed tomography,pulmonary function assessment,multiplex cytokine assay,and flow cytometry were performed,and Spearman correlation analysis was used to explore the potential correlation between inflammation and abnormal clinical features.Results: At 3 months after discharge,levels of pro-inflammatory cytokines and factors related to vascular injury/repair in recovered COVID-19 patients had not returned to those of the HC,especially among recovered SPs compared to recovered MPs and APs.These cytokines were significantly correlated with impaired pulmonary function and chest CT abnormalities.However,levels of immune cells had returned to nearly normal levels and were not significantly correlated with abnormal clinical features.Conclusion: Vascular injury,inflammation,and chemotaxis persisted in COVID-19 patients and were correlated with abnormal clinical features 3 months after discharge,especially in recovered SPs.Part ? Plasma Metabolomic Profiles and Clinical Features in Recovered COVID-19 Patients Without Previous Underlying Diseases 3 Months After DischargePurpose: The COVID-19 pandemic poses an unprecedented threat to global public health.Metabolism will emerge as a critical regulator of susceptibility to,recovery from and survival after COVID-19.Infectious diseases and host metabolic processes are intimately connected,and changes in host metabolism occur at all levels-cellular,tissue,organ and physiological-during infection.It remains unclear whether COVID-19 patients have fully recovered from severe complications and what the differences in the metabolic profile of patients with different severity after rehabilitation are.At the same time,elucidating the pathogenesis of COVID-19 might be helpful to discover new therapeutic targets.Methods: We prospectively included 96 COVID-19 patients with no previous underlying diseases 3 months after discharge,and divided them into three groups according to the severity of the disease at the time of admission: 18 recovered asymptomatic patients(RAPs),34 recoverd moderate patients(RMPs),44 recoverd severe and critical patients(RSPs)and healthy controls(HC).The plasma metabolomic and lipidomic profiles in 135 subjects were quantitatively analyzed,and blood biochemical index detection and chest CT scan were performed.Results: Clinical data showed that the laboratory test indicators(including blood routine,liver and kidney function,myocardial enzyme spectrum,coagulation function,CRP)of the recovered COVID-19 patients all returned to normal levels.However,as compared with HC,some parameters in RMPs and RSPs still had statistical differences.Our findings demonstrated that the plasma metabolic alterations progressed gradually in RA,RM and RS patients when compared with HC.Correlation analysis revealed that many differential metabolites were closely associated with the function of pulmonary,renal,hepatic,microbial and energetic metabolism and inflammation.Conclusion: These findings suggested that RM and RS patients may take more time to recover from SARS-Co V-2-caused damage and these patients should be followed up on regular basis for possible organ and system damage.