{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:46:46Z","timestamp":1790750806432,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T00:00:00Z","timestamp":1619740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The clinical evolution of COVID-19 pneumonia is poorly understood. Identifying the metabolic pathways that are altered early with viral infection and their association with disease severity is crucial to understand COVID-19 pathophysiology, and guide clinical decisions. This study aimed at assessing the critical metabolic pathways altered with disease severity in hospitalized COVID-19 patients. Forty-nine hospitalized patients with COVID-19 pneumonia were enrolled in a prospective, observational, single-center study in Barcelona, Spain. Demographic, clinical, and analytical data at admission were registered. Plasma samples were collected within the first 48 h following hospitalization. Patients were stratified based on the severity of their evolution as moderate (N = 13), severe (N = 10), or critical (N = 26). A panel of 221 biomarkers was measured by targeted metabolomics in order to evaluate metabolic changes associated with subsequent disease severity. Our results show that obesity, respiratory rate, blood pressure, and oxygen saturation, as well as some analytical parameters and radiological findings, were all associated with disease severity. Additionally, ceramide metabolism, tryptophan degradation, and reductions in several metabolic reactions involving nicotinamide adenine nucleotide (NAD) at inclusion were significantly associated with respiratory severity and correlated with inflammation. In summary, assessment of the metabolomic profile of COVID-19 patients could assist in disease severity stratification and even in guiding clinical decisions.<\/jats:p>","DOI":"10.3390\/ijms22094794","type":"journal-article","created":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T10:53:29Z","timestamp":1619780009000},"page":"4794","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":84,"title":["Metabolic Signatures Associated with Severity in Hospitalized COVID-19 Patients"],"prefix":"10.3390","volume":"22","author":[{"given":"Judith","family":"Mar\u00edn-Corral","sequence":"first","affiliation":[{"name":"Critical Care Department, Hospital del Mar, 08003 Barcelona, Spain"},{"name":"Critical Illness Research Group (GREPAC), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), 08003 Barcelona, Spain"},{"name":"Division of Pulmonary Diseases &amp; Critical Care Medicine, University of Texas Health San Antonio, San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8133-9983","authenticated-orcid":false,"given":"Jose","family":"Rodr\u00edguez-Morat\u00f3","sequence":"additional","affiliation":[{"name":"Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, IMIM-Institut Hospital del Mar d\u2019Investigacions M\u00e8diques, 08003 Barcelona, Spain"},{"name":"Department of Experimental and Health Sciences, Universitat Pompeu Fabra (CEXS-UPF), 08003 Barcelona, Spain"},{"name":"Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8172-1827","authenticated-orcid":false,"given":"Alex","family":"Gomez-Gomez","sequence":"additional","affiliation":[{"name":"Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, IMIM-Institut Hospital del Mar d\u2019Investigacions M\u00e8diques, 08003 Barcelona, Spain"},{"name":"Department of Experimental and Health Sciences, Universitat Pompeu Fabra (CEXS-UPF), 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6567-0916","authenticated-orcid":false,"given":"Sergi","family":"Pascual-Guardia","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Diseases &amp; Critical Care Medicine, University of Texas Health San Antonio, San Antonio, TX 78229, USA"},{"name":"Department of Experimental and Health Sciences, Universitat Pompeu Fabra (CEXS-UPF), 08003 Barcelona, Spain"},{"name":"Respiratory Department, Hospital del Mar, IMIM, 08003 Barcelona, Spain"},{"name":"CIBER de Enfermedades Respiratorias, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosana","family":"Mu\u00f1oz-Berm\u00fadez","sequence":"additional","affiliation":[{"name":"Critical Care Department, Hospital del Mar, 08003 Barcelona, Spain"},{"name":"Critical Illness Research Group (GREPAC), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0133-1349","authenticated-orcid":false,"given":"Anna","family":"Salazar-Degracia","sequence":"additional","affiliation":[{"name":"Critical Care Department, Hospital del Mar, 08003 Barcelona, Spain"},{"name":"Critical Illness Research Group (GREPAC), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Purificaci\u00f3n","family":"P\u00e9rez-Ter\u00e1n","sequence":"additional","affiliation":[{"name":"Critical Care Department, Hospital del Mar, 08003 Barcelona, Spain"},{"name":"Critical Illness Research Group (GREPAC), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9107-3405","authenticated-orcid":false,"given":"Marcos I.","family":"Restrepo","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Diseases &amp; Critical Care Medicine, University of Texas Health San Antonio, San Antonio, TX 78229, USA"},{"name":"Section of Pulmonary &amp; Critical Care Medicine, South Texas Veterans Health Care System, San Antonio, TX 78229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olha","family":"Khymenets","sequence":"additional","affiliation":[{"name":"Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, IMIM-Institut Hospital del Mar d\u2019Investigacions M\u00e8diques, 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noem\u00ed","family":"Haro","sequence":"additional","affiliation":[{"name":"Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, IMIM-Institut Hospital del Mar d\u2019Investigacions M\u00e8diques, 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan Ramon","family":"Masclans","sequence":"additional","affiliation":[{"name":"Critical Care Department, Hospital del Mar, 08003 Barcelona, Spain"},{"name":"Critical Illness Research Group (GREPAC), Institut Hospital del Mar d\u2019Investigacions M\u00e8diques (IMIM), 08003 Barcelona, Spain"},{"name":"Department of Medicine, Universitat Aut\u00f2noma de Barcelona (UAB), 08193 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1735-9728","authenticated-orcid":false,"given":"Oscar J.","family":"Pozo","sequence":"additional","affiliation":[{"name":"Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, IMIM-Institut Hospital del Mar d\u2019Investigacions M\u00e8diques, 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/S1473-3099(20)30120-1","article-title":"An interactive web-based dashboard to track COVID-19 in real time","volume":"20","author":"Dong","year":"2020","journal-title":"Lancet Infect. 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