Network-Based Multiomics Integration Reveals Immunometabolic Convergence Between COVID-19 and Pulmonary Arterial Hypertension.

Abstract

Coronavirus disease 2019 and pulmonary arterial hypertension (PAH) are clinically distinct disorders that converge on severe pulmonary vascular dysfunction, endothelial injury, and cardiopulmonary failure. However, the shared systems-level molecular architecture linking acute, virus-induced vascular damage with chronic pulmonary vascular remodeling remains undefined. To address this critical gap, we conducted a novel, integrative multilayered network analysis. By simultaneously combining transcriptome profiles of lung tissue samples with protein-protein interaction, metabolic, and regulatory networks, we systematically compared the previously unmapped molecular landscapes of both conditions. Despite their distinct upstream triggers-immune receptor-dominated signaling in acute severe acute respiratory syndrome coronavirus 2 infection versus remodeling- and ion channel-associated signaling in PAH-cross-disease integration revealed a highly structured, convergent immunometabolic regulatory architecture. This core is defined by extensive transcriptional reprogramming and the coordinated rewiring of oxidative phosphorylation and acetyl-CoA-associated metabolism. Taken together, these findings define a systems-level convergence model that mechanistically links acute viral endothelial injury and chronic pulmonary vasculopathy through a shared immunometabolic axis. This integrative molecular framework provides a new foundation for prioritizing candidate biomarkers and therapeutic nodes that target the overlapping vascular and inflammatory mechanisms of both conditions.