text: Plasma metabolomic profiling of patients recovered from COVID 19 with pulmonary sequelae 3 months after discharge Elucidation of the molecular mechanisms involved in the pathogenesis of coronavirus disease COVID 19 may help to discover therapeutic targets To determine the metabolomic profile of circulating plasma from COVID 19 survivors with pulmonary sequelae 3 months after discharge a random outcome stratified case control sample was analyzed We enrolled 103 recovered COVID 19 patients as well as 27 healthy donors and performed pulmonary function tests computerized tomography CT scans laboratory examinations and liquid chromatography mass spectrometry Plasma metabolite profiles of COVID 19 survivors with abnormal pulmonary function were evidently different from those of healthy donors or subjects with normal pulmonary function These alterations were associated with disease severity and mainly involved amino acid and glycerophospholipid metabolic pathways Furthermore increased levels of triacylglycerols phosphatidylcholines prostaglandin E2 arginine and decreased levels of betain and adenosine were associated with pulmonary CO diffusing capacity and total lung capacity The global plasma metabolomic profile differed between subjects with abnormal and normal pulmonary function Further metabolite based analysis may help to identify the mechanisms underlying pulmonary dysfunction in COVID 19 survivors and provide potential therapeutic targets in the future 