Exploiting Bacteria for Improving Hypoxemia of COVID-19 Patients

Abstract

Background: Although useful in the time-race against COVID-19, CPAP cannot provide oxygen over the physiological limits imposed by severe pulmonary impairments. In previous studies, we reported that the administration of the SLAB51 probiotics reduced risk of developing respiratory failure in severe COVID-19 patients through the activation of oxygen sparing mechanisms providing additional oxygen to organs critical for survival. Methods: This “real life” study is a retrospective analysis of SARS-CoV-2 infected patients with hypoxaemic acute respiratory failure secondary to COVID-19 pneumonia undergoing CPAP treatment. A group of patients managed with ad interim routinely used therapy (RUT) were compared to a second group treated with RUT associated with SLAB51 oral bacteriotherapy (OB). Results: At baseline, patients receiving SLAB51 showed significantly lower blood oxygenation than controls. An opposite condition was observed after 3 days of treatment, despite the significantly reduced amount of oxygen received by patients taking SLAB51. At 7 days, a lower prevalence of COVID-19 patients needing CPAP in the group taking probiotics was observed. The administration of SLAB51 is a complementary approach for ameliorating oxygenation conditions at the systemic level. Conclusion: This study proves that probiotic administration results in an additional boost in alleviating hypoxic conditions, permitting to limit on the use of CPAP and its contraindications.

Bacterial Lysate from the Multi-Strain Probiotic SLAB51 Triggers Adaptative Responses to Hypoxia in Human Caco-2 Intestinal Epithelial Cells under Normoxic Conditions and Attenuates LPS-Induced Inflammatory Response

“…In conclusion, our data can partially explain the beneficial effects recorded following treatment with SLAB51 in animal models and patients with hypoxia-related conditions [31][32][33][34][35][36]. Despite this, to furnish the multi-strain SLAB51 probiotic with an authorized health claim approved by a regulatory agency, such as the U.S. Food and Drug Administration (FDA) or the European Food Safety Authority (EFSA), evidence has to be provided through well-designed human trials.…”

“…SLAB51 is a probiotic mixture consisting of Streptococcus thermophilus (DSM 32245), B. lactis (DSM 32246), B. lactis (DSM 32247), L. acidophilus (DSM 32241), L. helveticus (DSM 32242), L. paracasei (DSM 32243), L. plantarum (DSM 32244), and L. brevis (DSM 27961), previously studied both in vitro and in vivo, in animal models and patients, on hypoxia-related conditions [31][32][33][34][35][36]. Bacterial species present within this multi-strain probiotic formulation constitute common inhabitants of the human gut, mostly ingested with food, especially dairy products [37,38].…”

Probiotics for the prevention and treatment of COVID-19: a rapid systematic review and meta-analysis

“…We included 18 studies (11 RCTs and 7 observational studies) in our review (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). The details of the screening process are presented in Figure 1.…”

SLAB51 Multi-Strain Probiotic Formula Increases Oxygenation in Oxygen-Treated Preterm Infants

“…Probiotics can also release substances or induce direct responses from the host cells by influencing specific metabolic pathways and could also positively impact body sites other than the colon due to communication axes linking the colonic microbes with other organs and tissues [22][23][24]. Studies on adult COVID-19 patients with pneumonia have shown that administering multi-strain probiotics, i.e., SLAB51, could increase oxygenation [15,16]. Since the effect on oxygen saturation generally occurs as early as 2-3 h after ingestion, while any ingested food takes 6-8 h to reach and pass the ileocecal valve, it has been postulated that SLAB51 exerts its action in the intestine before colonizing the colon.…”

“…In recent studies, the administration of the multi-strain probiotic SLAB51 was associated with significantly higher blood levels of both the partial pressure of oxygen (pO 2 ) and the arterial oxygen saturation (SaO 2 ) in adult COVID-19 patients with pneumonia treated with non-invasive ventilation [15,16]. These results highlight the ability of this multi-strain probiotic formulation to influence the redistribution of oxygen throughout the body through a possible oxygen-sparing effect involving the stabilization of HIF1α at the intestine level, in agreement with results published by Lombardi and colleagues [17].…”