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To reduce mortality and costs, tailored early interventions for at\u2010risk patients are essential. This study elucidates the association between longitudinal metabolomic profiles and COVID\u201019 severity and progression. We analyzed metabolomic profiles from a subset of the BEAT\u2010COVID cohort, a modestly sized yet well\u2010characterized and longitudinally sampled COVID\u201019 cohort. The study comprises hospitalized patients sampled approximately twice weekly for up to 60 days after symptom onset during the first (29 patients,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200992 samples) and second (48 patients,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009112 samples) waves. Alongside sampling, daily disease severity was assessed using the Severity of Coronavirus Disease Assessment (SCODA) score. Associations were analyzed using univariate and multivariate linear mixed\u2010effect models. Perturbations in the tryptophan\u2010kynurenine pathway, linoleic acid derivatives, endocannabinoids, and sphingosines were significantly associated with disease severity and progression. These metabolic changes correlated with immune markers reflecting COVID\u201019 severity. Some observed potential differences between the two waves could be partially attributed to the influence of corticosteroid treatment introduced during the second wave. Once confirmed in an independent validation cohort, the identified oxidative stress\u2010 and inflammation\u2010related metabolites may serve as biomarkers of disease progression, help identify at\u2010risk hospitalized patients, and provide potential therapeutic targets.\n                  <\/jats:p>","DOI":"10.1002\/jmv.71030","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T08:59:55Z","timestamp":1783587595000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tracking COVID\u201019 Severity and Progression Through Amines and Lipid Mediators"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3024-6286","authenticated-orcid":false,"given":"Melissa","family":"Goris","sequence":"first","affiliation":[{"name":"Metabolomics and Analytics Center, Leiden Academic Center for Drug Research (LACDR) Leiden University Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merys","family":"Valdez","sequence":"additional","affiliation":[{"name":"Metabolomics and Analytics Center, Leiden Academic Center for Drug Research (LACDR) Leiden University Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lieke","family":"Lamont","sequence":"additional","affiliation":[{"name":"Metabolomics and Analytics Center, Leiden Academic Center for Drug Research (LACDR) Leiden University Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yang","sequence":"additional","affiliation":[{"name":"Metabolomics and Analytics Center, Leiden Academic Center for Drug Research (LACDR) Leiden University Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Harms","sequence":"additional","affiliation":[{"name":"Metabolomics and Analytics Center, Leiden Academic Center for Drug Research (LACDR) Leiden University Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naama","family":"Karu","sequence":"additional","affiliation":[{"name":"Tasmanian Independent Metabolomics and Analytical Chemistry Solutions (TIMACS) Hobart Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Bos","sequence":"additional","affiliation":[{"name":"Metabolomics and Analytics Center, Leiden Academic Center for Drug Research (LACDR) Leiden University Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelte","family":"Geerlings","sequence":"additional","affiliation":[{"name":"Metabolomics and Analytics Center, Leiden Academic Center for Drug Research (LACDR) Leiden University Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Ottenhoff","sequence":"additional","affiliation":[{"name":"Leiden University Center for Infectious Diseases Leiden University Medical Center (LUMC) Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3466-5401","authenticated-orcid":false,"given":"Roula","family":"Tsonaka","sequence":"additional","affiliation":[{"name":"Department of Biomedical Data Sciences Leiden University Medical Center (LUMC) Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna HE","family":"Roukens","sequence":"additional","affiliation":[{"name":"Leiden University Center for Infectious Diseases Leiden University Medical Center (LUMC) Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Sesmu","family":"Arbous","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine Leiden University Medical Center (LUMC) Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone A.","family":"Joosten","sequence":"additional","affiliation":[{"name":"Leiden University Center for Infectious Diseases Leiden University Medical Center (LUMC) Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Hankemeier","sequence":"additional","affiliation":[{"name":"Metabolomics and Analytics Center, Leiden Academic Center for Drug Research (LACDR) Leiden University Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alida","family":"Kindt","sequence":"additional","affiliation":[{"name":"Metabolomics and Analytics Center, Leiden Academic Center for Drug Research (LACDR) Leiden University Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"In collaboration with BEAT\u2010COVID group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"WHO Coronavirus (COVID\u201019) Dashboard | WHO Coronavirus (COVID\u201019) Dashboard With Vaccination Data https:\/\/covid19.who.int\/."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.14657"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/metabo13030342"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","unstructured":"D.Biagini M.Franzini P.Oliveri T.Lomonaco Plasma Oxylipin Levels May Predict Covid\u201019 Patient Outcomes. 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