Figure 5 Lipid Changes in Exosomes of COVID-19 Patients (A) Lipid changes in isolated exosomes from plasma of healthy controls (n = 25) and COVID-19 patients (n = 50). Colored dots (blue and red) in volcano plot indicate lipids that were significantly different (p < 0.05) between healthy controls and COVID-19 patients. Blue dots indicate significant lipids with fold change ≥ 2 in COVID-19 patients relative to controls listed in the blue panel, while red dots indicate significant lipids with fold change < 2 in patients relative to controls (listed in red and green panels). Lipids on the right side of vertical line at x = 0 were increased in COVID-19 patients compared to controls (blue and red panels), and lipids on the left side were decreased in COVID-19 patients compared to controls (green panel). (B) Boxplots illustrate sum of all GM3s (p = 0.0037), and three representatives, GM3 d18:0/26:0 (p = 0.0008), GM3 d18:1/16:0 (p = 0.0017), and GM3 d18:1/24:1 (p = 0.0015), that displayed increasing trends in isolated exosomes from healthy controls to COVID-19 patients of increasing severity. Exosome lipids were expressed in nanomoles of lipids per gram of total protein (nmol/g protein). (C) Volcano plots illustrate exosome lipids that were significantly different (p < 0.05) in pairwise comparisons indicated on top of each plot. Dots corresponding to significant lipids (p < 0.05) were colored (blue and red), and lipids with fold change ≥ 2 were colored blue and listed in the blue panel accompanying each volcano plot, while lipids with fold change < 2 were colored red. See also Figure S5.