a Summary of tryptophan metabolism pathways in asymptomatic (n = 53), mild (n = 54), severe (n = 33), and critical (n = 21) COVID-19 patients (IDO, indoleamine 2,3-dioxygenase; KAT, kynurenine aminotransferase; MAO, monoamine oxidase; TDO, tryptophan 2,3-dioxygenase). Box plots show expression level change (log2(x + 1)) of selected regulated metabolites across four disease severities. We performed comparisons between arbitrary two groups. P values were calculated using Mann–Whitney U test (two-sided) and significant P values were shown in boxplot. b Boxplots of mRNA for (ARG1, ARG2) and metabolic abundance of arginine metabolism pathway components (L-arginine, N-acetylornithine, L-glutamine). We performed comparisons between arbitrary two groups. The mRNA analysis included asymptomatic (n = 64), mild (n = 64), severe (n = 34), and critical (n = 16) COVID-19 patients. P values were calculated using Wald test (two-sided) and significant P values were shown in boxplot. The metabolites analysis included asymptomatic (n = 53), mild (n = 54), severe (n = 33), and critical (n = 21) COVID-19 patients. P values were calculated using Mann–Whitney U test (two-sided) and significant P values were shown in boxplot. c Relative expression abundance of exhaustion marker genes CTLA4, BTLA, HAVCR2, ICOS, and PDCD1 in T cells in asymptomatic (n = 64), mild (n = 64), severe (n = 34), and critical (n = 16) COVID-19 patients. Relative expression abundance of exhaustion marker genes was defined as their expression levels divided by expression level of T cell marker gene CD3E. We performed comparisons between arbitrary two groups. P values were calculated using Wald test (two-sided) and significant P values were shown in boxplot. The bold lines, upper boundaries and lower boundaries of notches represent the medians, 75th percentiles and 25th percentiles, respectively. Whiskers extend 1.5 times interquartile range (IQR). * means adjusted P value ≤ 0.05, ** means adjusted P value ≤ 0.01, *** means adjusted P value ≤ 0.001 and **** means P ≤ 0.0001, if not indicated, means adjusted P value > 0.05. Multiple comparisons adjustment was performed using Benjamini-Hochberg (BH) method. Exact P value and source data were included in the Source Data file.