Gut Dysbiosis and IL-21 Response in Patients with Severe COVID-19

Abstract

Background: The disease severity, ranging from being asymptomatic to having acute illness, and associated inflammatory responses has suggested that alterations in the gut microbiota may play a crucial role in the development of chronic disorders due to COVID-19 infection. This study describes gut microbiota dysbiosis in COVID-19 patients and its implications relating to the disease. Design: A cross sectional prospective study was performed on thirty RT-PCR-confirmed COVID-19 patients admitted to the All India Institute of Medical Sciences, Bhopal, India, between September 10 and 20, 2020. Ten healthy volunteers were recruited as the control group. IFN, TNF, and IL-21 profiling was conducted using plasma samples, and gut bacterial analysis was performed after obtaining the metagenomics data of stool samples. Results: Patients with a variable COVID-19 severity showed distinct gut microflora and peripheral interleukin-21 levels. A low Firmicute/Bacteroidetes ratio, caused by the depletion of the fibre-utilizing bacteria, F. prausnitzii, B. Plebius, and Prevotella, and an increase in Bacteroidetes has associated gut microbiota dysbiosis with COVID-19 disease severity. Conclusions: The loss of the functional attributes of signature commensals in the gut, due to dysbiosis, is a predisposing factor of COVID-19 pathophysiology.

Correlation Analysis between Gut Microbiota Alterations and the Cytokine Response in Patients with Coronavirus Disease during Hospitalization

“…The findings showed that in the first 3 weeks after the onset of illness, four main classes (Clostridia, Bacilli, Coriobacteriia, and Bacteroidia) showed alterations compared with the composition noted in healthy subjects. In particular, the abundance of Firmicutes was observed to decrease immediately after disease onset, which is consistent with the findings of previous reports ( 9 , 17 ). The gut microbiota observed in this study can be seen as a dysbiotic pattern associated with high intestinal oxygenation.…”

Dissecting the Role of the Human Microbiome in COVID-19 via Metagenome-assembled Genomes

“…For example, Citrobacter freundii was found to be significantly enriched in COVID-19 patients with fever 57 . Veillonella parvula 18,40,54 and Parabacteroides distasonis 18,58 were also shown to be a shared signature of COVID-19 in multiple studies. Importantly, we observed some opportunistic pathogens were associated with the progression of COVID-19, including nrMAGs from Klebsiella quasivariicola 41 , Klebsiella pneumoniae 42 , and Escherichia coli 43 .…”

Probióticos – uma espada ou um escudo no desfecho da COVID-19?

“…Ao avaliar a composição da microbiota fecal de indivíduos saudáveis e com COVID-19, foi observado, em nível de Filo, um maior aumento relativo na proporção de Bacteroidetes em pacientes com COVID-19, em relação aos indivíduos saudáveis (23,9% e 12,8%, respectivamente) (Yeoh et al, 2021). A gravidade da COVID-19 também pode ser associada à disbiose ao observar uma redução na razão Firmicute/Bacteroidete decorrente da redução populacional de F. prausnitzii, B. plebeus e Provotella, fermentadores de fibra, associadas ao aumento de Bacteroidetes (Khan et al, 2021). Por outro lado, foi observado um maior aumento relativo de Actinobacterias entre os indivíduos saudáveis em comparação ao grupo doente (26,1% e 19,0%) (Yeoh et al, 2021), corroborando com os dados encontrados por Khan et al (2021) Além disso, mesmo com poucos dados, deve ser dada a devida atenção a coinfecção por S. aureus em pacientes COVID-19.…”

“…A gravidade da COVID-19 também pode ser associada à disbiose ao observar uma redução na razão Firmicute/Bacteroidete decorrente da redução populacional de F. prausnitzii, B. plebeus e Provotella, fermentadores de fibra, associadas ao aumento de Bacteroidetes (Khan et al, 2021). Por outro lado, foi observado um maior aumento relativo de Actinobacterias entre os indivíduos saudáveis em comparação ao grupo doente (26,1% e 19,0%) (Yeoh et al, 2021), corroborando com os dados encontrados por Khan et al (2021) Além disso, mesmo com poucos dados, deve ser dada a devida atenção a coinfecção por S. aureus em pacientes COVID-19. Pois mesmo com baixas taxas de coinfecção reportadas, quando presente, pode desdobrar em complicações levando a COVID-19 de forma grave e aumenta a chance de morte do paciente em decorrência de tal coinfecção (Adeiza et al, 2020;Araújo et al, 2021;Garcia-Vidal et al, 2021;Mahmoudi, 2020).…”