Gut-brain communication in COVID-19: molecular mechanisms, mediators, biomarkers, and therapeutics

Wais, Tameena; Hasan, Mehde; Rai, Vikrant; Agrawal, Devendra K.

doi:10.1080/1744666x.2022.2105697

Cited by 13 publications

(30 citation statements)

References 115 publications

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“…We considered the action of antibiotics primarily on bacteria (the carriers of viral replication and toxicological production related to the infectious event in the microbiome). We found a link between the state of hypercoagulation and neurological and cardiac disorders, which requires more investigation with further studies to consider that neurological symptoms like hyposmia and ageusia could be linked to gastrointestinal issues 62–64 . Toxin‐like peptides originating from the gut microbiome in COVID‐19 patients can be suppressed with antibiotics in vitro.…”

Section: Introductionmentioning

confidence: 84%

“…On the other hand, we have observed how the rest of the bacterial flora does not remain undisturbed but induces the production of abnormal toxin-like peptides, found in the plasma of COVID-19 patients. 64 It produces to exhaustion even during the stasis phase and non-replication of the pathogen on the bacterial matrix of the microbiome. 61 In these works, antibiograms were performed during the early stages of viral pathogen colonization on the bacterial flora.…”

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confidence: 99%

“…During the COVID-19 pandemic, many studies showed bacterial co-infection in sick people, with an increase in the more aggressive bacterial species and a steady decrease in the beneficial ones. 59,60 In previous work, 30,[61][62][63][64] we analyzed the replication aspects of SARS-CoV-2, in bacteria of human origin from the gut microbiome and observed how SARS-CoV-2 imposes an initial lytic behavior toward the healthy bacterial species of the microbiome and then assumed a lysogenic behavior. On the other hand, we have observed how the rest of the bacterial flora does not remain undisturbed but induces the production of abnormal toxin-like peptides, found in the plasma of COVID-19 patients.…”

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confidence: 99%

“…SARS-CoV-2 disrupts the human microbiome and can replicate within bacteria. 29,30,[62][63][64] Antibiotic efficacy against bacterial replication and toxin production was assessed in our in vitro studies, 29,30,[62][63][64] and also other researchers' studies take into evidence the gut-brain axis 65 in SARS-CoV-2 infection.…”

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confidence: 99%

“…Antibiotics were administered based on NIH, WHO guidelines, and previous research. 29,30,[61][62][63][64][65][66][67][68] The impact of these drugs on the development or resolution of long COVID (LC) was also analysed.…”

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confidence: 99%

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A retrospective cohort study on early antibiotic use in vaccinated and unvaccinated COVID‐19 patients

Brogna,

Montano,

Zanolin

et al. 2024

Journal of Medical Virology

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The bacteriophage behavior of SARS‐CoV‐2 during the acute and post‐COVID‐19 phases appears to be an important factor in the development of the disease. The early use of antibiotics seems to be crucial to inhibit disease progression—to prevent viral replication in the gut microbiome, and control toxicological production from the human microbiome. To study the impact of specific antibiotics on recovery from COVID‐19 and long COVID (LC) taking into account: vaccination status, comorbidities, SARS‐CoV‐2 wave, time of initiation of antibiotic therapy and concomitant use of corticosteroids and nonsteroidal anti‐inflammatory drugs (NSAIDs). A total of 211 COVID‐19 patients were included in the study: of which 59 were vaccinated with mRNA vaccines against SARS‐CoV‐2 while 152 were unvaccinated. Patients were enrolled in three waves: from September 2020 to October 2022, corresponding to the emergence of the pre‐Delta, Delta, and Omicron variants of the SARS‐CoV‐2 virus. The three criteria for enrolling patients were: oropharyngeal swab positivity or fecal findings; moderate symptoms with antibiotic intake; and measurement of blood oxygen saturation during the period of illness. The use of antibiotic combinations, such as amoxicillin with clavulanic acid (875 + 125 mg tablets, every 12 h) plus rifaximin (400 mg tablets every 12 h), as first choice, as suggested from the previous data, or azithromycin (500 mg tablets every 24 h), plus rifaximin as above, allows healthcare professionals to focus on the gut microbiome and its implications in COVID‐19 disease during patient care. The primary outcome measured in this study was the estimated average treatment effect, which quantified the difference in mean recovery between patients receiving antibiotics and those not receiving antibiotics at 3 and 9 days after the start of treatment. In the analysis, both vaccinated and unvaccinated groups had a median illness duration of 7 days (interquartile range [IQR] 6–9 days for each; recovery crude hazard ratio [HR] = 0.94, p = 0.700). The median illness duration for the pre‐Delta and Delta waves was 8 days (IQR 7–10 days), while it was shorter, 6.5 days, for Omicron (IQR 6–8 days; recovery crude HR = 1.71, p < 0.001). These results were confirmed by multivariate analysis. Patients with comorbidities had a significantly longer disease duration: median 8 days (IQR 7–10 days) compared to 7 days (IQR 6–8 days) for those without comorbidities (crude HR = 0.75, p = 0.038), but this result was not confirmed in multivariate analysis as statistical significance was lost. Early initiation of antibiotic therapy resulted in a significantly shorter recovery time (crude HR = 4.74, p < 0.001). Concomitant use of NSAIDs did not reduce disease duration and in multivariate analysis prolonged the disease (p = 0.041). A subgroup of 42 patients receiving corticosteroids for a median of 3 days (IQR 3–6 days) had a longer recovery time (median 9 days, IQR 8–10 days) compared to others (median 7 days, IQR 6–8 days; crude HR = 0.542, p < 0.001), as confirmed also by the adjusted HR. In this study, a statistically significant reduction in recovery time was observed among patients who received early antibiotic treatment. Early initiation of antibiotics played a crucial role in maintaining higher levels of blood oxygen saturation. In addition, it is worth noting that a significant number of patients who received antibiotics in the first 3 days and for a duration of 7 days, during the acute phase did not develop LC.

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Section: Introductionmentioning

confidence: 84%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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A retrospective cohort study on early antibiotic use in vaccinated and unvaccinated COVID‐19 patients

Brogna,

Montano,

Zanolin

et al. 2024

Journal of Medical Virology

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Antibiotics in COVID‐19: Unveiling disturbing truths through critical scrutiny

Kow,

Ramachandram,

Hasan

et al. 2024

Journal of Medical Virology

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and long-term consequences of antibiotic therapy in COVID-19 management. Additionally, alternative treatment approaches, such as antiviral medications and supportive care, should be explored to optimize patient outcomes while minimizing the risk of antibiotic resistance and microbiome disruption. AUTHOR CONTRIBUTIONS Chia Siang Kow: Conceptualization; roles/writing-original draft; writing-review and editing; final approval of the version to be published. Dinesh Sangarran Ramachandram: Conceptualization; roles/writing-original draft; writing-review and editing; final approval of the version to be published. Syed Shahzad Hasan: Roles/writing-original draft; writing-review and editing; final approval of the version to be published. Kaeshaelya Thiruchelvam: Roles/writing-original draft; writing-review and editing;

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Pitfalls and Traps in the Surgical Evaluation of Patients with Irritable Bowel Syndrome (IBS)

Zaza

Alverdy

2023

Journal of Gastrointestinal Surgery

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Gut-brain communication in COVID-19: molecular mechanisms, mediators, biomarkers, and therapeutics

Cited by 13 publications

References 115 publications

A retrospective cohort study on early antibiotic use in vaccinated and unvaccinated COVID‐19 patients

A retrospective cohort study on early antibiotic use in vaccinated and unvaccinated COVID‐19 patients

Antibiotics in COVID‐19: Unveiling disturbing truths through critical scrutiny

Pitfalls and Traps in the Surgical Evaluation of Patients with Irritable Bowel Syndrome (IBS)

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