Metabolomic Biomarkers of Pulmonary Fibrosis in COVID‐19 Patients One Year After Hospital Discharge

ABSTRACT Coronavirus disease 2019 (COVID‐19) global pandemic has affected more than 600 million people up to date. The symptomatology and severity of COVID‐19 are very broad, and there are still concerns about the long‐term sequelae that it can have on discharged patients. The development of pulmonary fibrotic sequelae after this infection is especially worrying. Our aim was to determine if there was a metabolomic signature that could predict the development of pulmonary fibrotic sequelae. It is a multicenter prospective observation subcohort based on the COVID‐FIBROTIC study. A metabolomic analysis was performed by nuclear magnetic resonance (NMR) on serum samples from patients admitted with bilateral COVID‐19 pneumonia collected 2 months after hospital discharge. One year after admission, clinical, functional and radiological data were collected from these same patients. Finally, 109 patients (mean age 57.68 [DS14.03], 65.13% male) were available. Fibrotic sequelae 1 year after COVID‐19 disease were found in 33% of them. Based on the NMR analysis of the serum samples, it was possible to distinguish with 80.82% of sensitivity, 72.22% of specificity and 0.83 of an area under the curve (AUC) value which patients would have radiological signs of pulmonary fibrotic pattern 1 year after sample collection. According to the metabolites participating in the discriminative model and the univariate statistics, glucose, valine, and fatty acids (═CH–CH2–CH═) were suggested as potential biomarkers of the development of pulmonary fibrotic sequelae after COVID‐19. Trial Registration Number clinicaltrials.gov NCT04409275 (June 1, 2020).