A better understanding of the metabolic alterations in immune cells during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may elucidate the wide diversity of clinical symptoms experienced by individuals with coronavirus disease 2019 (COVID-19). Here, we report the metabolic changes associated with the peripheral immune response of 198 individuals with COVID-19 through an integrated analysis of plasma metabolite and protein levels as well as single-cell multiomics analyses from serial blood draws collected during the first week after clinical diagnosis. We document the emergence of rare but metabolically dominant T cell subpopulations and find that increasing disease severity correlates with a bifurcation of monocytes into two metabolically distinct subsets. This integrated analysis reveals a robust interplay between plasma metabolites and cell-type-specific metabolic reprogramming networks that is associated with disease severity and could predict survival.

更好地了解严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 感染期间免疫细胞的代谢变化，可能会阐明 2019 冠状病毒病 (COVID-19) 患者所经历的临床症状的广泛多样性。在这里，我们通过对血浆代谢物和蛋白质水平的综合分析以及对临床诊断后第一周收集的连续抽血的单细胞多组学分析，报告了与 198 名 COVID-19 患者外周免疫反应相关的代谢变化. 我们记录了罕见但代谢占优势的 T 细胞亚群的出现，并发现疾病严重程度的增加与单核细胞分叉为两个代谢不同的亚群相关。