Studying the blood plasma of people diagnosed with covid-19 in search of biomarkers that indicate the risk of the patient developing the severe form of the disease has been the goal of researchers around the world. A work along these lines was recently published by a group from the University of São Paulo (USP) in the Journal of Proteome Research.
At the São Carlos Institute of Chemistry (IQSC-USP), the team coordinated by Professor Daniel R. Cardoso analyzed the blood plasma of 110 patients with flu symptoms who were admitted, still in 2020, at the Hospital of the Federal University of São Paulo (Unifesp ). Among these individuals, 57 (control group) were not infected with the new coronavirus, while 53 tested positive for Sars-CoV-2. Among those infected, ten had complications and were admitted to the intensive care unit (ICU) and two died.
In patients infected with the new coronavirus, it was possible to observe variations in the concentration of six substances (metabolites) produced naturally by our body and that are found in the blood: glycerol, acetate, 3-aminoisobutyrate, formate, glucuronate and lactate. The greater the imbalance in the amount of these metabolites at the beginning of the infection, the more serious people’s health conditions became. The investigation was supported by Fapesp.
“What we saw in patients who progressed to severe cases of covid-19 is that there was a more accentuated change in the concentration of these compounds when they sought medical care”, says Banny Correia, a postdoctoral fellow at IQSC-USP and one of the authors of the article. .
According to Cardoso, by monitoring the amount of these six substances produced by different metabolic pathways, it is possible to have a prognosis on how severe the infection will be. “That way, when the patient seeks help, the doctor will be able to predict through a clinical examination if he will need hospitalization and, thus, act quickly to prevent the evolution of the disease”, he evaluates.
According to the professor, the new coronavirus causes changes in different metabolic processes in the human body, especially in energy production pathways, regardless of the variant of Sars-CoV-2.
“The Sars-CoV-2 virus infects the cell, alters its metabolism and uses energy pathways to replicate itself. From there, variations occur in the amount of those six substances, with some having their concentration reduced and others increased. of imbalance in the concentration of these compounds indicates how much the metabolism was affected, allowing us to predict whether the patient’s clinical conditions will worsen”, he reports.
Understand the technique used
In the research, blood samples were analyzed by high-field nuclear magnetic resonance spectroscopy – a technique that requires sophisticated equipment present in one of the IQSC-USP laboratories. According to the researchers, however, the evaluation can also be done through simple clinical tests performed in laboratories and hospitals, focusing specifically on the panel of metabolites identified in the research. “The result is ready quickly”, says Correia.
The researchers’ expectation is that the new method will become a protocol adopted by hospitals in the future. To validate the technique, in the next steps of the research, the scientists plan to expand the number of blood plasma samples to be evaluated and include new groups in the study, such as vaccinates who contract covid-19, for example.
Another goal is to include gender and age information in the statistics. “In addition to covid-19, this type of analysis could help discover marker metabolites that predict severity in other viral infections and help a faster response in future pandemics”, concludes Cardoso.
The article H qNMR-Based Metabolomics Discrimination of Covid-19 Severity can be read at: https://pubs.acs.org/doi/10.1021/acs.jproteome.1c00977.
*With information from the IQSC-USP Communications Office.