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An alternative approach is to use cohorts of patients in routine clinical care, but this necessitates identification of relevant comparator groups. In infectious disease one option is to compare patients with a current infection with those who are convalescent. This approach has been applied using opportunistically collected biological samples from the Manchester Allergy, Respiratory and Thoracic Surgery Biobank COVID-19 cohort unimmunised hospitalised or convalescent patients for whom extensive clinical data and classical biomarker analysis are available. Pilot serum lipidomic and proteomic profiling was undertaken employing novel, rapid mass spectrometry methods. The cohort comprised 222 individuals, 25% of whom were of non-white ethnicity, 68% of whom were male and 66% were either overweight or obese. Around half (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009116) were classified as severe based on symptomology using the WHO score, with a patient management score (the Manchester Severity Score) splitting the WHO \u201ccritical\u201d category into two further sub-categories. Stratification of patients into those who had a current infection or were convalescent using both severity scores provided consistent results in analysis of classical cellular and biochemical markers. For example, C-reactive protein (CRP) was higher (mean 74.5\u00a0mg\/L) in those with a current infection compared to those who were convalescent (mean 35.1\u00a0mg\/L). Pilot multiomics analysis using novel methodology showed good reproducibility and identified lipid and protein biomarkers previously observed in COVID-19 infections including phosphatidyl cholines, triglycerides and C-reactive protein. The relative quantification of CRP by proteomics was correlated with conventional measurements. These data demonstrate the feasibility of using samples from patients who have either a current infection, or who are convalescent, as comparators and that the multiomics analysis pipeline is suitable for wider lipidomic and proteomic analysis in future.\n                  <\/jats:p>","DOI":"10.1186\/s12879-026-13070-7","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T10:15:47Z","timestamp":1774952147000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characterisation of a cohort of opportunistically recruited patients with COVID-19 and approaches to patient stratification"],"prefix":"10.1186","volume":"26","author":[{"given":"Shaufa","family":"Shareef","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Matthews","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Dodds","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alasdair","family":"Silverberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew E.","family":"Daly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waqar","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Bannard-Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee A.","family":"Gethings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"King","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Fowler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Felton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Simpson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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The biobank is approved through the UK Health Research Authority (HRA) National Health Service Research Ethics Committee (REC) application number NREC 15\/NW\/0409. The REC was the North West \u2013 Haydock Research Ethics Committee. Full informed consent was given from participants before any samples were collected. Clinical data was collected from patients\u2019 medical records for the interpretation of laboratory sample analysis and was annonymised prior to release to researchers. The Biobank operates according to the UK legislation and the UK Health Research Authority requirements which framed within the Declaration of Helsinki. Consequently, a clinical trial number is not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"L.A.G., M.E. 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