Research Information System
Turk Hijyen ve Deneysel Biyoloji Dergisi, vol.81, no.4, pp.387-398, 2024 (Scopus, TRDizin)
Objective: Ever since Covid-19 outbreak in Wuhan, China, medical scientists actively strive to contribute in the diagnosis and management of the disease. For this purpose, many markers have been studied so far for the follow-up and prognosis of the disease, apart from these routine tests, the number of targeted and untargeted metabolomic studies have been growing gradually. Organic acids are the intermediate products in various metabolic pathways. Abnormal urinary organic acids can be present in amino acid and carbohydrate metabolism disorders, mitochondrial fatty acid beta oxidation disorders, and some mitochondrial oxidative phosphorylation defects. The aim of this study is to evaluate the organic acids detected in the urine due to the metabolic processes that may be affected by hypoxia in Covid-19 patients who develop clinically mild, moderate and severe pneumonia, to determine their relationship with the disease severity and to compare the results with the control group. Methods: A total of 120 patients with the clinical spectrum of SARS-CoV-2 infection as mild, moderate and severe according to the WHO Covid-19 disease severity classification were included in the present study. First morning urine samples taken inpatient setting were aliquoted and frozen immediately until the analysis day. Urine organic acid levels were measured using Gas chromatography-mass spectrometry. Results: Among 104 organic acids, pyruvic acid, lactic acid, 2-hydroxybutyric acid levels were significantly higher in the severe disease group (p=0.006, p<0.001, p<0.001, respectively), citric acid and homovanilic acid (HVA) levels were significantly lower in all disease groups (p<0.001), α-ketoglutaric acid, vanillylmandelic acid and succinic acid levels were significantly lower in the severe and moderate disease group (p<0.001), β-hydroxybutyric acid was significantly higher in the severe and moderate disease group p(<0.001), oxalic acid was significantly higher in the moderate disease group compared to the control group (p=0.041). The binary logistic regression model included, α-ketoglutaric acid, succinic acid, and HVA. It was statistically significant with χ2 = 98.680; p < 0.001. Conclusion: α-ketoglutaric acid, succinic acid and HVA were independent predictors of the disease severity, measurement of these spesific metabolites might facilitate the developments of novel therapies and may improve responses to currently available therapies with the ease of prognosis prediction of Covid-19.