SARS-CoV-2-Indigenous Microbiota Nexus: Does Gut Microbiota Contribute to Inflammation and Disease Severity in COVID-19?

Chattopadhyay, Indranil; Shankar, Esaki Muthu

doi:10.3389/fcimb.2021.590874

Cited by 43 publications

(51 citation statements)

References 68 publications

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“…8 SARS-CoV-2 has been shown to use the receptors of angiotensin-converting enzyme-2 (ACE-2) as the cellular receptor system in the upper respiratory tract, and although the expression of ACE-2 in the gastrointestinal system is quite high, 9,10 the presence of GIS at varying rates and its effects on disease prognosis are still not fully explained. 11 In our study, it was observed that 71.4% of patients without GIS showed at least one of the symptoms after hospitalization and the frequency of development of intestinal disorders such as diarrhea-constipation increased as the disease severity increased. These findings suggest that the presence of GIS, which has a variable effect on the prognosis of the disease, may develop due to various factors (hospital infection, intensive antibiotic use, common proton pump inhibitor use, and specific treatments) rather than primary gastrointestinal system involvement of SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 56%

“…Although SARS-CoV-2 often manifests itself only with upper respiratory tract symptoms and signs of lung damage, the presence of gastrointestinal symptoms (GIS) which might be associated with intestinal dysbiosis affects mortality and morbidity. [1][2][3] The finding of whole genome sequencing in the stools gives an insight that damages in the gut is a possibility. 4 Gastrointestinal symptoms mostly manifest themselves as nausea, vomiting, abdominal pain, and rarely diarrhea.…”

Section: Introductionmentioning

confidence: 99%

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Gastrointestinal symptoms in COVID-19 could be associated with severe lung involvement and increased readmission rates

Bozkurt

Bilen

2021

Eur J Inflamm

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Introduction SARS-CoV-2 virus manifests itself with primary lung damage but also has intestinal involvement. In this study, we aimed to investigate the frequency of gastrointestinal symptoms (GIS) and the relationship of GIS with readmission to the hospital within 30 days in SARS-CoV-2 infected patients who were hospitalized in a specified pandemic hospital. Materials and Methods Symptomatic patients diagnosed with rapid antibody positivity with real-time polymerase chain reaction and typical thorax computed tomography findings were included in this retrospective cohort observational study. Demographic and clinical data were obtained from electronic medical records. Hospital-associated GIS were considered as experiencing at least one of the GIS such as gas, bloating, diarrhea, and constipation developing within72 h after hospital admission. Results The mean age of the patients was 58 ± 14.4 years and 60.7% were men. 82% of hospitalizations were a moderate and severe disease. 71.4% of patients without GIS had at least one of the GIS after hospitalization. As the severity of the disease increased, the frequency of the severity of gastrointestinal symptom increased. GIS bowel disorders were more prominent in patients with moderate and severe disease. Antibiotic and specific treatment (anti-Il-1, anti-Il-6) contributed to the occurrence of gastrointestinal symptom in SARS-CoV-2 inpatients. Conclusion According to our observations of the second wave of the pandemic, the presence, frequency, and severity of gastrointestinal symptom in inpatient is associated with severity of lung disease and increased readmission rate after discharge.

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Section: Discussionmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Gastrointestinal symptoms in COVID-19 could be associated with severe lung involvement and increased readmission rates

Bozkurt

Bilen

2021

Eur J Inflamm

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“…In this state, patients with severe COVID-19 may need to be admitted to the ICU for endotracheal intubation and mechanical ventilation. The evolution to COVID-19-ARDS is characterized by pulmonary edema, hypoxemia and inflammation, which are associated with changes in the lung microbiome (12). The microbiota is defined as the overall community of microbes included in a population (13), and the genetic content of the microbiota is known as the microbiome.…”

Section: Direct Lung Damage In Covid-19mentioning

confidence: 99%

The Role of Dysbiosis in Critically Ill Patients With COVID-19 and Acute Respiratory Distress Syndrome

et al. 2021

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In late December 2019, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) quickly spread worldwide, and the syndrome it causes, coronavirus disease 2019 (COVID-19), has reached pandemic proportions. Around 30% of patients with COVID-19 experience severe respiratory distress and are admitted to the intensive care unit for comprehensive critical care. Patients with COVID-19 often present an enhanced immune response with a hyperinflammatory state characterized by a “cytokine storm,” which may reflect changes in the microbiota composition. Moreover, the evolution to acute respiratory distress syndrome (ARDS) may increase the severity of COVID-19 and related dysbiosis. During critical illness, the multitude of therapies administered, including antibiotics, sedatives, analgesics, body position, invasive mechanical ventilation, and nutritional support, may enhance the inflammatory response and alter the balance of patients' microbiota. This status of dysbiosis may lead to hyper vulnerability in patients and an inappropriate response to critical circumstances. In this context, the aim of our narrative review is to provide an overview of possible interaction between patients' microbiota dysbiosis and clinical status of severe COVID-19 with ARDS, taking into consideration the characteristic hyperinflammatory state of this condition, respiratory distress, and provide an overview on possible nutritional strategies for critically ill patients with COVID-19-ARDS.

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“…Although much attention has been given to ACE2 expression in the respiratory tract, it is expressed at log-order higher levels in the intestinal system and gallbladder [ 45 ]. It has been demonstrated that, at least in mice, a deficiency of ACE2 causes inflammation, resulting in harmful alterations in the gut microbiome [ 46 ], which may be why gastrointestinal symptoms often accompany even mild cases of COVID-19.…”

Section: Connections Between the Lung And The Heartmentioning

confidence: 99%

“…Early observations from China have suggested that some COVID-19 patients suffered from dysbiosis with fewer Lactococcus and Bifidobacterium species in their gut. Infection with SARS-CoV-2 not only downregulates ACE2 expression in the lungs but also in the gut [ 45 ], and since ACE2 tightly controls the local production of antimicrobial peptides in the gut, this may have direct effects on the microbiome. Another explanation that has been put forward for gut dysbiosis is virus replication in the gut epithelial tissue.…”

Section: Probiotics and Covid-19mentioning

confidence: 99%

Interactions between the Gut Microbiome, Lung Conditions, and Coronary Heart Disease and How Probiotics Affect These

Wassenaar

Juncos

Zimmermann

2021

IJMS

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The importance of a healthy microbiome cannot be overemphasized. Disturbances in its composition can lead to a variety of symptoms that can extend to other organs. Likewise, acute or chronic conditions in other organs can affect the composition and physiology of the gut microbiome. Here, we discuss interorgan communication along the gut–lung axis, as well as interactions between lung and coronary heart diseases and between cardiovascular disease and the gut microbiome. This triangle of organs, which also affects the clinical outcome of COVID-19 infections, is connected by means of numerous receptors and effectors, including immune cells and immune-modulating factors such as short chain fatty acids (SCFA) and trimethlamine–N–oxide (TMAO). The gut microbiome plays an important role in each of these, thus affecting the health of the lungs and the heart, and this interplay occurs in both directions. The gut microbiome can be influenced by the oral uptake of probiotics. With an improved understanding of the mechanisms responsible for interorgan communication, we can start to define what requirements an ‘ideal’ probiotic should have and its role in this triangle.

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SARS-CoV-2-Indigenous Microbiota Nexus: Does Gut Microbiota Contribute to Inflammation and Disease Severity in COVID-19?

Cited by 43 publications

References 68 publications

Gastrointestinal symptoms in COVID-19 could be associated with severe lung involvement and increased readmission rates

Gastrointestinal symptoms in COVID-19 could be associated with severe lung involvement and increased readmission rates

The Role of Dysbiosis in Critically Ill Patients With COVID-19 and Acute Respiratory Distress Syndrome

Interactions between the Gut Microbiome, Lung Conditions, and Coronary Heart Disease and How Probiotics Affect These

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