Association of SARS-CoV-2 and Polypharmacy with Gut–Lung Axis: From Pathogenesis to Treatment

Abstract

SARS-CoV-2 is a novel infectious contagion leading to COVID-19 disease. The virus has affected the lives of millions of people across the globe with a high mortality rate. It predominantly affects the lung (respiratory system), but it also affects other organs, including the cardiovascular, psychological, and gastrointestinal (GIT) systems. Moreover, elderly and comorbid patients with compromised organ functioning and pre-existing polypharmacy have worsened COVID-19-associated complications. Microbiota (MB) of the lung plays an important role in developing COVID-19. The extent of damage mainly depends on the predominance of opportunistic pathogens and, inversely, with the predominance of advantageous commensals. Changes in the gut MB are associated with a bidirectional shift in the interaction among the gut with a number of vital human organs, which leads to severe disease symptoms. This review focuses on dysbiosis in the gut–lung axis, COVID-19-induced worsening of comorbidities, and the influence of polypharmacy on MB.

Functional Foods: A Promising Strategy for Restoring Gut Microbiota Diversity Impacted by SARS-CoV-2 Variants

“…Coprobacillus was found to upregulate the expression of ACE2, while Bacteroides thetaiotaomicron, Bacteroides dorei, and Bacteroides massiliensis were found to downregulate ACE2 expression in the gut of patients. Overall, these findings suggest that harmful bacteria and the absence of beneficial bacteria in the gut are closely related to the severity of COVID-19 [54][55].…”

The effect of synbiotic adjunct therapy on clinical and paraclinical outcomes in hospitalized COVID‐19 patients: A randomized placebo‐controlled trial

“…IL-6 plays a key role in elevating inflammatory responses during SARS-CoV-2 infection as the main proinflammatory marker. 28 Some studies the significant enhancement of IL-6 serum levels in patients who suffered COVID-19 infection, 17,[29][30][31] and the elevated mentioned cytokine is significantly associated with adverse clinical outcomes such as ICU admission and mortality. 32 Based on recent investigations, the overexpression of IL-6 in viral infections leads to the progression of the disease and multiorgan failure.…”

“…Based on recent investigations, the overexpression of IL‐6 in viral infections leads to the progression of the disease and multiorgan failure 28 . Promising approaches such as probiotic adjunct therapy might be essential to modulate the hyperinflammatory responses against COVID‐19 17 …”

“…According to previous studies, probiotics, and prebiotics could enhance body defense against COVID‐19 and other respiratory infections via augmentation of the mucosal barrier and modulating the inflammatory process and immune responses 14,15 . Accordingly, probiotic and prebiotic supplementation is proposed as a promising prospect regarding adjunct treatment against COVID‐19 based on the efficiency, safety, well tolerability without serious adverse side effects, and low cost of mentioned therapy 15‐18 …”

Severity of COVID-19 in Patients with Diarrhoea: A Systematic Review and Meta-Analysis

“…As a result, we may infer that in individuals infected with COVID-19 and diarrhoea were more likely to be severely ill than those COVID-19 patients without diarrhoea. According to studies, changes in the microbiome of the gut are associated with a bidirectional shift in the interaction between the gut and a number of major organs, leading to severe disease symptoms explaining the gut–lung axis link in COVID-19 [ 99 ].…”