Lipidomic and metabolomic changes in community-acquired and COVID-19 pneumonia.

Internal Medicine Department, Quiron Salud Hospital, Barcelona, Spain. Research Group of Autoimmunity, Infection and Thrombosis (GRAIIT), Pere Virgili for Health Research Institute (IISPV), Rovira and Virgili University (URV), Reus, Spain; Internal Medicine Department, "Sant Joan" University Hospital, Reus, Spain. Electronic address: sandra.parra@urv.cat. Biosfer Teslab, Reus, Spain; Department of Basic Medical Sciences, Rovira and Virgili University (URV), Pere Virgili for Health Research Institute (IISPV), Tarragona, Spain. Biosfer Teslab, Reus, Spain; Department of Basic Medical Sciences, Rovira and Virgili University (URV), Pere Virgili for Health Research Institute (IISPV), Tarragona, Spain; Centre for Biomedical Research Network on Diabetes and Associated Metabolic Diseases (CIBERDEM), ISCIII, Madrid, Spain. Research Group of Autoimmunity, Infection and Thrombosis (GRAIIT), Pere Virgili for Health Research Institute (IISPV), Rovira and Virgili University (URV), Reus, Spain; Internal Medicine Department, "Sant Joan" University Hospital, Reus, Spain. Research Group of Autoimmunity, Infection and Thrombosis (GRAIIT), Pere Virgili for Health Research Institute (IISPV), Rovira and Virgili University (URV), Reus, Spain; Clinical laboratory Department, "Sant Joan" University Hospital, Reus, Spain. Centre for Biomedical Research Network on Diabetes and Associated Metabolic Diseases (CIBERDEM), ISCIII, Madrid, Spain; Department of Electronic Engineering, Rovira and Virgili University (URV), Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain. Rheumatology department, "Sant Joan" University Hospital, Reus, Spain. Centre for Biomedical Research Network on Diabetes and Associated Metabolic Diseases (CIBERDEM), ISCIII, Madrid, Spain; Lipids and Arteriosclerosis Research Unit, Rovira and Virgili University (URV), Reus, Spain; Pere Virgili for Health Research Institute (IISPV), Tarragona, Spain.

Journal of lipid research. 2024;(9):100622
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Abstract

This prospective observational study compared the 1H NMR blood lipidomes and metabolomes of 71 patients with community-acquired pneumonia (CAP), 75 patients with COVID-19 pneumonia, and 75 healthy controls (matched by age and sex) to identify potential biomarkers and pathways associated with respiratory infections. Both pneumonia groups had comparable severity indices, including mortality, invasive mechanical ventilation, and intensive care unit admission rates. Patients with COVID-19 pneumonia exhibited more pronounced hypolipidemia, with significantly lower levels of total cholesterol and LDL-c compared to patients with CAP. Atherogenic lipoprotein subclasses (VLDL-cholesterol, IDL-cholesterol, IDL-triglyceride, and LDL-triglyceride/LDL-cholesterol) were significantly increased in severe cases of both pneumonia types, while lower HDL-c and small, dense HDL particles were associated with more severe illness. Both infected groups showed decreased esterified cholesterol and increased triglycerides, along with reduced phosphatidylcholine, lysophosphatidylcholine, PUFA, omega-3 fatty acids, and DHA. Additionally, infected patients had elevated levels of glucose, lactate, 3-hydroxybutyrate, and acetone, which are linked to inflammation, hypoxemia, and sepsis. Increased levels of branched-chain amino acids, alanine, glycine, and creatine, which are involved in energy metabolism and protein catabolism, were also observed. Neurotransmitter synthesis metabolites like histidine and glutamate were higher in infected patients, especially those with COVID-19. Notably, severe infections showed a significant decrease in glutamine, essential for lymphocyte and macrophage energy. The severity of COVID-19 pneumonia was also associated with elevated glycoprotein levels (glycoprotein A, glycoprotein B, and glycoprotein F), indicating an inflammatory state. These findings suggest that metabolomic and lipidomic changes in pneumonia are connected to bioenergetic pathways regulating the immune response.

Methodological quality

Publication Type : Observational Study

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