A metabolic readout of the urine metabolome of COVID-19 patients.

Analysis of urine samples from COVID-19 patients by 1H NMR reveals important metabolic alterations due to SAR-CoV-2 infection. Previous studies have identified biomarkers in urine that reflect metabolic alterations in COVID-19 patients. We have used 1H NMR to better define these metabolic alterations since this technique allows us to obtain a broad profile of the metabolites present in urine. This technique offers the advantage that sample preparation is very simple and gives us very complete information on the metabolites present. To detect these alterations, we have compared urine samples from COVID-19 patients (n = 35) with healthy people (n = 18). We used unsupervised (Robust PCA) and supervised (PLS-LDA) multivariate analysis methods to evaluate the differences between the two groups: COVID-19 and healthy controls. The differences focus on a group of metabolites related to energy metabolism (glucose, ketone bodies, glycine, creatinine, and citrate) and other processes related to bacterial flora (TMAO and formic acid) and detoxification (hippuric acid). The alterations in the urinary metabolome shown in this work indicate that SARS-CoV-2 causes a metabolic change from a normal situation of glucose consumption towards a gluconeogenic situation and possible insulin resistance.

[Microangiopathic hemolytic anemia and leukoerythroblastosis as the presenting form of a gastric adenocarcinoma]. / Anemia hemolítica microangiopática y leucoeritroblastosis como forma de presentación de un adenocarcinoma gástrico.

Among the hematologic complications associated to cancer, microangiopathic hemolytic anemia and leukoerythroblastosis are rarely reported together. We present the case of a patient with gastric adenocarcinoma that presented clinically with microangiopathic hemolytic anemia and leukoerythroblastosis in peripheral blood as a result of metastatic invasion of the bone marrow. We discuss the probable etiopathogenic relation of these two entities with cancer, the therapeutic possibilities and the primary role of bone marrow biopsy and examination of the peripheral blood smear as more reliable diagnostic methods.