Determination of Glycan Urinary Biomarkers in the Urine of COVID-19 Positive and Negative Individuals Using Bottom-up Glycomics

Based on past studies, urinary glycan biomarkers have the potential to be used as diagnostic and prognostic markers for treatment purposes. This study brought into play the bottom-up glycan node analysis approach to analyze 39 urine samples from COVID-19 positive and negative individuals using gas chromatography-mass spectrometry (GC-MS) to determine potential urinary glycan biomarkers of COVID-19. Glycan node analysis involves chemically breaking down glycans in whole biospecimens in a way that conserves both monosaccharide identity and linkage information that facilitates the capture of unique glycan features as single analytical signals. Following data acquisition, the student t-test was done on all the nodes, but only four prominent nodes (t-Deoxyhexopyranose, 2,3-Gal, t-GlcNAc, and 3,6-GalNAc with respective p-values 0.03027, 0.03973, 0.0224, and 0.0004) were below the threshold p-value of 0.05 and showed some differences in the mean between both groups. To eliminate the probability of having false positive p-values, Bonferroni correction was done on the four nodes but only the 3,6-GalNAc node emerged as the only node that was below the newly adjusted p-value. Because sample analyses were done in batches, the Kruskal Wallis test was done to know if the batch effect was responsible for the observed lower relative concentration of 3,6-GalNAc in COVID-19 positive patients than in negative patients. A receiver operating characteristic curve (ROC) was plotted for the 3,6-GalNAc node and the area under the curve (AUC) was calculated to be 0.84, casting the 3,6-GalNAc node was a potential biomarker of COVID-19. 3,6-GalNAc largely arises from branched O-glycan core structures, which are abundant in mucin glycoproteins that line the urogenital tract. Lowered relative concentrations of 3,6-GalNAc in the urine of COVID-19 positive patients may be explained by compromised kidney function that allows non-mucinous glycoproteins from the blood to contribute a greater proportion of the relative glycan node signals than in COVID-19 negative patients. Future prospective clinical studies will be needed to validate both the biomarker findings and this hypothesis.