{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T02:19:03Z","timestamp":1783477143493,"version":"3.55.0"},"reference-count":54,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Pregnancy being an immune compromised state, coronavirus disease of 2019 (COVID\u201019) disease poses high risk of premature delivery and threat to fetus. Plasma metabolome regulates immune cellular responses, therefore we aimed to analyze the change in plasma secretome, metabolome, and immune cells with disease severity in COVID\u201019 positive pregnant females and their cord blood. COVID\u201019 reverse transcriptase\u2010polymerase chain reaction positive pregnant females (<jats:italic>n<\/jats:italic>\u2009=\u2009112) with asymptomatic (Asy) (<jats:italic>n<\/jats:italic>\u2009=\u200982), mild (<jats:italic>n<\/jats:italic>\u2009=\u200921), or moderate (<jats:italic>n<\/jats:italic>\u2009=\u20099) disease, healthy pregnant (<jats:italic>n<\/jats:italic>\u2009=\u200918), COVID\u201019 positive nonpregnant females (<jats:italic>n<\/jats:italic>\u2009=\u20097) were included. Eighty\u2010two cord blood from COVID\u201019 positive and seven healthy cord blood were also analyzed. Mother's peripheral blood and cord blood were analyzed for untargeted metabolome profiling and cytokines by using high\u2010resolution mass spectrometry and cytokine bead array. Immune scan was performed only in mothers' blood by flow cytometry. In Asy severe acute respiratory syndrome coronavirus 2 infection, the amino acid metabolic pathways such as glycine, serine, <jats:sc>l<\/jats:sc>\u2010lactate, and threonine metabolism were upregulated with downregulation of riboflavin and tyrosine metabolism. However, with mild\u2010to\u2010moderate disease, the pyruvate and nicotinamide adenine dinucleotide (NAD<jats:sup>+<\/jats:sup>) metabolism were mostly altered. Cord blood mimicked the mother's metabolomic profiles by showing altered valine, leucine, isoleucine, glycine, serine, threonine in Asy and NAD<jats:sup>+<\/jats:sup>, riboflavin metabolism in mild and moderate. Additionally, with disease severity tumor necrosis factor\u2010\u03b1, interferon (IFN)\u2010\u03b1, IFN\u2010\u03b3, interleukin (IL)\u20106 cytokine storm, IL\u20109 was raised in both mothers and neonates. Pyruvate, NAD metabolism and increase in IL\u20109 and IFN\u2010\u03b3 had an impact on nonclassical monocytes, exhausted T and B cells. Our results demonstrated that immune\u2010metabolic interplay in mother and fetus is influenced with increase in IL\u20109 and IFN\u2010\u03b3 regulated pyruvate, lactate tricarboxylic acid, and riboflavin metabolism with context to disease severity.<\/jats:p>","DOI":"10.1002\/jmv.29257","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T17:33:52Z","timestamp":1701884032000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Metabolic alterations unravel the maternofetal immune responses with disease severity in pregnant women infected with SARS\u2010CoV\u20102"],"prefix":"10.1002","volume":"95","author":[{"given":"Sandhya","family":"Hora","sequence":"first","affiliation":[{"name":"Department of Molecular and Cellular Medicine, Laboratory of Molecular Immunology Institute of Liver and Biliary Sciences New Delhi 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