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

Abstract

BackgroundAlthough numerous modalities are currently in use for the treatment and prophylaxis of COVID-19, probiotics are a cost-effective alternative that could be used in diverse clinical settings. Hence, we conducted a meta-analysis to investigate the role of probiotics in preventing and treating COVID-19 infection.MethodsWe searched several databases from inception to 30 May 2023 for all randomized controlled trials (RCTs) and comparative observational studies that evaluated probiotics (irrespective of the regimen) for the treatment or prevention of COVID-19. We conducted our meta-analysis using RevMan 5.4 with risk ratio (RR) and mean difference (MD) as the effect measures.ResultsA total of 18 studies (11 RCTs and 7 observational studies) were included in our review. Probiotics reduced the risk of mortality (RR 0.40; 95% CI: 0.25–0.65, I2 = 0%). Probiotics also decreased the length of hospital stay, rate of no recovery, and time to recovery. However, probiotics had no effect on the rates of ICU admission. When used prophylactically, probiotics did not decrease the incidence of COVID-19 cases (RR 0.65; 95% CI: 0.37–1.12; I2 = 66%). The results for all outcomes were consistent across the subgroups of RCTs and observational studies (P for interaction >0.05).ConclusionThe results of this meta-analysis support the use of probiotics as an adjunct treatment for reducing the risk of mortality or improving other clinical outcomes in patients with COVID-19. However, probiotics are not useful as a prophylactic measure against COVID-19. Large-scale RCTs are still warranted for determining the most efficacious and safe probiotic strains.Systematic Review RegistrationPROSPERO (CRD42023390275: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=390275).

A Narrative Review on Gut Microbiome Disturbances and Microbial Preparations in ME/CFS: Implications for Long COVID

“…In addition, metabolites of microbial origin, by acting on the gut-brain axis can influence brain function [83] with favorable effects on mood and sleep; as well as reduced depression, anger and fatigue [84]. Similar benefits were also observed in hospitalized COVID patients, who after receiving probiotic supplementation, especially with Lactobacillus and Bifidobacterium strains [85] had reduced overall symptoms, including lowered inflammatory reactions, decreased the duration of hospitalization and recovery time, what may suggest that probiotics may have potential to reduce mortality resultant from this condition [86].…”

A Narrative Review on Gut Microbiome Disturbances and Microbial Preparations in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Implications for Long COVID

“…In addition, metabolites of microbial origin, by acting on the gut-brain axis, can influence brain function [85], with favorable effects on mood and sleep and reduced depression, anger and fatigue [86]. Similar benefits were also observed in hospitalized COVID patients, who, after receiving probiotic supplementation, especially with Lactobacillus and Bifidobacterium strains [87], had reduced overall symptoms, including lowered inflammatory reactions, decreased hospitalization duration and recovery time, which may suggest that probiotics may have the potential to reduce mortality resultant from this condition [88].…”

Alterations in microbiota of patients with COVID‐19: implications for therapeutic interventions

“… 159 , 160 A meta‐analysis found that probiotics shortened the length of hospital stay, recovery time, and reduced the risk of death, suggesting the potential of probiotics as an adjuvant therapy to reduce the risk of death and symptoms in COVID‐19. 161 Based on the gut–lung axis theory, there is a bidirectional interaction between gut microbiota and lung. Probiotics reduce serum C‐reactive protein levels, shorten the length of hospital stay, and further improve respiratory symptoms through the gut–lung axis.…”