Evidence map›Paper›PMID 42216049›Full record

ArticleGenome medicine2026

Systemic multi-omics analysis reveals interferon response heterogeneity and links lipid metabolism to immune alterations in severe COVID-19.

Ronaldo Lira-Junior, Anoop T Ambikan, Axel Cederholm, Sefanit Rezene, Flora Mikaeloff, Sara Svensson Akusjärvi, Ahmet Yalcinkaya, Xi Chen, Maike Sperk, Maribel Aranda-Guillén and 5 more

Abstract read
In one paragraph

Article in Genome medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Ronaldo Lira-Junior *Division of Oral Diagnostics & Surgery, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
Anoop T Ambikan *The Systems Virology Laboratory, Division of Clinical Microbiology, Department of Laboratory Medicine, ANA Futura, Karolinska Institutet, Stockholm, 141 52, Sweden.
Axel Cederholm *Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.
Sefanit Rezene *The Systems Virology Laboratory, Division of Clinical Microbiology, Department of Laboratory Medicine, ANA Futura, Karolinska Institutet, Stockholm, 141 52, Sweden.
Flora MikaeloffThe Systems Virology Laboratory, Division of Clinical Microbiology, Department of Laboratory Medicine, ANA Futura, Karolinska Institutet, Stockholm, 141 52, Sweden.
Sara Svensson AkusjärviThe Systems Virology Laboratory, Division of Clinical Microbiology, Department of Laboratory Medicine, ANA Futura, Karolinska Institutet, Stockholm, 141 52, Sweden.
Ahmet YalcinkayaScience for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.
Xi ChenThe Systems Virology Laboratory, Division of Clinical Microbiology, Department of Laboratory Medicine, ANA Futura, Karolinska Institutet, Stockholm, 141 52, Sweden.
Maike SperkThe Systems Virology Laboratory, Division of Clinical Microbiology, Department of Laboratory Medicine, ANA Futura, Karolinska Institutet, Stockholm, 141 52, Sweden.
Maribel Aranda-GuillénCentre for Molecular Medicine, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden.
Hampus NordqvistDepartment of Infectious Diseases/Venhälsan, South General Hospital, Stockholm, Sweden.
Carl Johan TreutigerDepartment of Infectious Diseases/Venhälsan, South General Hospital, Stockholm, Sweden.
Nils LandegrenScience for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.
Ujjwal NeogiThe Systems Virology Laboratory, Division of Clinical Microbiology, Department of Laboratory Medicine, ANA Futura, Karolinska Institutet, Stockholm, 141 52, Sweden.
Soham GuptaThe Systems Virology Laboratory, Division of Clinical Microbiology, Department of Laboratory Medicine, ANA Futura, Karolinska Institutet, Stockholm, 141 52, Sweden. soham.gupta@ki.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInterferons play a central role in antiviral defense, but their dysregulation contributes to inflammation and immune dysfunction in respiratory viral infections, including COVID-19. While interferon-stimulated genes (ISGs) are essential effectors of this response, their expression patterns in patients are heterogeneous and not always predictive of disease severity. The immunometabolic consequences of this heterogeneity remain poorly understood.

methodsWe analyzed hospitalized COVID-19 patients (n = 37) and uninfected controls (n = 31) using whole-blood transcriptomics, immune cell deconvolution, plasma proteomics, and standardized plasma metabolomics from a previously generated dataset within this cohort. Patients were stratified into low (LIS), moderate (MIS), and high (HIS) ISG score clusters. Plasma innate immune activation markers were measured by ELISA. Interferon-directed antibody reactivity was analyzed by multiplex bead-based assays measuring antigen reactivity. Functional immune responses were assessed via ex vivo stimulation of healthy donor immune cells with patient plasma, and correlations were performed between metabolites and immune activation markers.

resultsHIS patients exhibited increased inflammatory mediators and innate immune cell expansion compared with LIS and MIS groups. However, within the HIS group, severe cases displayed distinct metabolic and immune dysregulation. Specifically, severe HIS cases showed reductions in phospholipids, sphingolipids, and tricarboxylic acid cycle intermediates, suggestive of disrupted mitochondrial and lipid metabolism. Plasma from severe HIS patients tended to impair neutrophil and monocyte activation, indicating functional attenuation of innate immune activation within a shared high-ISG background. Correlation analysis revealed that branched-chain lipids, tryptophan-derived metabolites, and a branched-chain dicarboxylic acid were positively associated with immune activation markers. Although type-I interferon neutralization was detected in a subset of patients with IFN antigen reactivity, these samples did not fully account for the observed ISG heterogeneity or disease severity.

conclusionsHigh ISG expression in COVID-19 defines a transcriptional endotype associated with systemic inflammation and innate immune activation. However, severe cases within this group exhibit metabolic constraints and reduced innate immune responsiveness, supporting an immune-metabolic axis in which inflammatory mediators and altered lipid/energy metabolism intersect with innate immune function. These findings motivate future studies to determine whether interferon-associated immune-metabolic states during acute infection relate to persistent inflammation or post-acute sequelae in selected patient subsets.

Indexed as

COVID-19InterferonsLipid MetabolismAdultAgedBiomarkersFemaleHumansImmunity, InnateMaleMetabolomicsMiddle AgedMultiomicsProteomicsSARS-CoV-2Severity of Illness IndexBiomarkersInterferonsCOVID-19Immune-metabolic dysregulationInterferon autoantibodyInterferon-stimulated genes (ISGs)Metabolic changesNeutrophil activationType I interferons

Identifiers

PMID42216049
PMCPMC13220500

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.