Polyunsaturated fatty acid–derived lipid mediator patterns determine viral pneumonia severity and risk for critical COVID-19

M Maria Papadaki (Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens) E Eleftherios Pavlos (Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens) M Marc Dubourdeau (Ambiotis Société par Actions Simplifiée) V Vincent Bailif (Ambiotis Société par Actions Simplifiée) K Kamal Badirou (Ambiotis Société par Actions Simplifiée) C Clémence A. Gély (Ambiotis Société par Actions Simplifiée) I Ioanna-Evdokia Galani (Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens) D Dimitris Papelis (Division of Pharmacology-Pharmacotechnology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens) N Natalia Kamperi (Division of Pharmacology-Pharmacotechnology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens) V Vasiliki Triantafyllia (Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens) E Eleni Siouti (Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens) M Maria Salagianni (Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens) M Maria Manioudaki (Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens) N Nikolaos Paschalidis (Center of Basic Research, Biomedical Research Foundation of the Academy of Athens) G Giannis Vatsellas (Center of Basic Research, Biomedical Research Foundation of the Academy of Athens) E Evangelia Koukaki (Intensive Care Unit, 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens, Medical School, ‘Sotiria’ General Hospital of Chest Diseases) V Vasiliki Rapti (3rd Department of Internal Medicine, “Sotiria” General Hospital of Chest Diseases, National and Kapodistrian University of Athens) D Dimitris Thanos (Center of Basic Research, Biomedical Research Foundation of the Academy of Athens) N Nikoletta Rovina (Intensive Care Unit, 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens, Medical School, ‘Sotiria’ General Hospital of Chest Diseases) G Garyfallia Poulakou (3rd Department of Internal Medicine, “Sotiria” General Hospital of Chest Diseases, National and Kapodistrian University of Athens) A Aurélie Cobat (St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University) J Jean-Laurent Casanova C Constantin Tamvakopoulos (Division of Pharmacology-Pharmacotechnology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens) E Evangelos Andreakos (Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens)

Abstract

Severe respiratory infections such as COVID-19 are characterized by excessive inflammation leading to the development of pneumonia and acute respiratory distress syndrome. Bioactive lipid mediators (LMs) derived from ω6 and ω3 polyunsaturated fatty acids are central to the regulation of inflammation, controlling both its initiation and resolution. Still, their role in viral infections remains underexplored. By employing a holistic approach involving the analysis of white blood cell transcriptomes, targeted lipidomics, cytokine and immune cell profiling, we now show that LM patterns around hospital admission are profoundly altered in COVID-19, correlate with inflammatory responses, and stratify patients according to disease severity. Central to this are CYP450-derived LMs, such as 20-HETE, and lipoxygenase- or nonenzymatic-associated LMs such as 15-HETE, both exhibiting vasoactive function, along with lipid peroxidation metabolites such as 10-HDOHE. Among them, increased 20-HETE appears to be a promising prognostic biomarker for ICU admission and a potential therapeutic target for severe COVID-19 disease. Our study emphasizes the importance of LM patterns in COVID-19 pathophysiology and sheds light into the broader immune mechanisms beyond cytokines driving viral pneumonia in humans.

Article Details

Volume / Issue Vol. 123, Issue 23
Published June 09, 2026
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (24)

M

Maria Papadaki

Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens

E

Eleftherios Pavlos

Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens

M

Marc Dubourdeau

Ambiotis Société par Actions Simplifiée

V

Vincent Bailif

Ambiotis Société par Actions Simplifiée

K

Kamal Badirou

Ambiotis Société par Actions Simplifiée

C

Clémence A. Gély

Ambiotis Société par Actions Simplifiée

I

Ioanna-Evdokia Galani

Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens

D

Dimitris Papelis

Division of Pharmacology-Pharmacotechnology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens

N

Natalia Kamperi

Division of Pharmacology-Pharmacotechnology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens

V

Vasiliki Triantafyllia

Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens

E

Eleni Siouti

Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens

M

Maria Salagianni

Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens

M

Maria Manioudaki

Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens

N

Nikolaos Paschalidis

Center of Basic Research, Biomedical Research Foundation of the Academy of Athens

G

Giannis Vatsellas

Center of Basic Research, Biomedical Research Foundation of the Academy of Athens

E

Evangelia Koukaki

Intensive Care Unit, 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens, Medical School, ‘Sotiria’ General Hospital of Chest Diseases

V

Vasiliki Rapti

3rd Department of Internal Medicine, “Sotiria” General Hospital of Chest Diseases, National and Kapodistrian University of Athens

D

Dimitris Thanos

Center of Basic Research, Biomedical Research Foundation of the Academy of Athens

N

Nikoletta Rovina

Intensive Care Unit, 1st Department of Respiratory Medicine, National and Kapodistrian University of Athens, Medical School, ‘Sotiria’ General Hospital of Chest Diseases

G

Garyfallia Poulakou

3rd Department of Internal Medicine, “Sotiria” General Hospital of Chest Diseases, National and Kapodistrian University of Athens

A

Aurélie Cobat

St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University

J

Jean-Laurent Casanova

C

Constantin Tamvakopoulos

Division of Pharmacology-Pharmacotechnology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens

E

Evangelos Andreakos

Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens