Oral Bacteriotherapy in Patients With COVID-19: A Retrospective Cohort Study

Abstract

Background: Mounting evidence suggests SARS-CoV-2 may impact on host microbiota and gut inflammation, infecting intestinal epithelial cells. This possible link and its implications can be investigated by observing the effects of modulation of the microbial flora in patients with COVID-19. The aim of this study was to compare the rate of mortality, the need of ICU hospitalization and the length of hospitalization in patients with severe COVID-19 pneumonia who received the best available therapy (BAT) vs. patients treated with BAT and supplemented with oral bacteriotherapy.Methods: This retrospective, observational cohort study included 200 adults with severe COVID-19 pneumonia. All patients received therapeutic regimens including low molecular weight heparin plus one or more between hydroxychloroquine, azithromycin, antivirals, and Tocilizumab. Oral bacteriotherapy was used as complementary treatment.Results: Out of the 200 patients, 112 received BAT without oral bacteriotherapy, and 88 BAT with oral bacteriotherapy. Crude mortality was 22%. Eleven percent died in the group of patients treated with BAT plus oral bacteriotherapy vs. 30% subjects in the group of patients managed only with BAT (p < 0.001). By multivariate analysis, the age >65 years, CRP >41.8 mg/L, Platelets <150.000 mmc, and cardiovascular events were associated with the increased risk of mortality. Oral bacteriotherapy was an independent variable associated with a reduced risk for death. Despite large prospective trials are needed, this study highlights a possible role for oral bacteriotherapy in the management of patients hospitalized for COVID-19 pneumonia.

Targeting Microbiome: An Alternative Strategy for Fighting SARS-CoV-2 Infection

“…By contrast, we found a longer length of hospitalization in patients receiving bacteriotherapy. We interpreted this data in line with the lower mortality rate of this group [55]. Interestingly, no adverse reactions in patients treated with oral bacteriotherapy were recorded in both studies.…”

“…Consistent with previous findings, these immunomodulatory benefits seem to be equally crucial in COVID-19 patients. Based on these shreds of evidence, our group ad-dressed the topic over the past year, carrying out 2 retrospective observational studies including adults with severe COVID-19 pneumonia to investigate the role of oral bacteriotherapy on the top of best available therapy [54,55].…”

“…In the second study, we extended our sample size. We focused our observation on mortality, ICU admission, and length of hospital staying of patients with COVID-19 pneumonia receiving probiotics as complementary therapy [55]. Out of 200 patients enrolled, 88 received oral bacteriotherapy (Sivomixx ® ).…”

“…Summary of studies and trials addressing the role of probiotics in the prevention and treatment of COVID-19[54][55][56][57][58][59][60][61][62][63][64] …”

Gut Microbiota and Probiotics/Synbiotics for Modulation of Immunity in Critically Ill Patients

“…Probiotics/synbiotics are one of the promising therapies for COVID-19 to maintain gut microbiota and prevent the exacerbation of pneumonia [ 39 ]. In 200 adults with severe COVID-19 pneumonia, patients treated with several kinds of probiotics were associated with a reduced risk for death [ 65 ]. Intestinal therapy for COVID-19 might be important to prevent pneumonia and systemic inflammation.…”