Gut microbiota changes are detected in asymptomatic very young children with SARS-CoV-2 infection

Abstract

We read with great interest the recent article by Yeoh et al, demonstrating an altered stool microbiome composition in patients with COVID-19 compared with controls, with greater dysbiosis correlating with elevated inflammatory markers. 1 Additionally, dysbiosis was seen after disease resolution. 1 To our knowledge, gut microbiome studies in young children with COVID-19 have not been reported. Critically, the developing gut microbiome of very young children differs from adults and establishes immune and inflammatory pathways. 2 3 Moreover, children with COVID-19 can subsequently develop autoimmune and autoinflammatory diseases including Multisystem Inflammatory Syndrome in Children (MIS-C) 4 5 , which may in part be microbiome mediated, given recent findings by Yeoh et al. 1 It is difficult to study this in young children, as many with SARS-CoV-2 infection are asymptomatic and rarely tested. 6 To address this, knowing that SARS-CoV-2 can be detected in stool, 7 we used an established study collecting longitudinal stool samples from before and throughout the pandemic to investigate the prevalence and associated microbiome changes of SARS-CoV-2 in very young children. We ran the CDC 2019-Novel Coronavirus Real-Time RT-PCR Diagnostic Panel assay on 769 serial stool samples from 595 children aged 0-24 months collected from February 2020 to February 2021. The prevalence of SARS-CoV-2 in faeces was 1.7% (13 samples from 13 separate children) with prevalence at <2 days and 2, 6, 12 and 24 months of 0% (0/1), 0% (0/21), 2.6% (4/156), 2.0% (7/357) and 0.9%,(2/234), respectively. Prevalence by month is shown in online supplemental figure 1A, with the first positive sample detected 31 days before the first reported case of COVID-19 regionally. No samples were positive in controls collected prior to the pandemic in 2019 (n=97 samples from 66 individuals). Of 13 positive children, 12 were asymptomatic with no personal or family history of SARS-CoV-2 (table 1A). Of 13 children, 1 was symptomatic with COVID-19 diagnosed 21 days before stool was collected. Hispanic ethnicity

Impact of SARS-CoV-2 on the microbiota of pregnant women and their infants

“…The composition of the oral microbiome is established early in life, is stable throughout life ( 65, 66 ), and it has implications for long-term health ( 67, 68 ). Despite oral microbiota changes in infants, we did not observe an effect of SARS-CoV-2 infection during pregnancy on the offspring’s gut microbiota, similar to previously reported ( 69 ). However, we observed that infants born to pregnant women with active infection presented elevated fecal calprotectin levels indicative of a pro-inflammatory tone early in life.…”

Gut microbiota in COVID-19: key microbial changes, potential mechanisms and clinical applications

“…Preliminary data showed that an altered gut microbiome in nine children with COVID-19 aged between 7 and 139 months was dominated by the genus Pseudomonas , and this change persisted for weeks after hospital discharge 45 . In 12 asymptomatic young children aged 0–24 months with SARS-CoV-2 infection, depletion of Bifidobacterium bifidum and Akkermansia muciniphila , which are linked to protection against inflammation, were observed in SARS-CoV-2-positive faecal samples 46 . Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 has been increasingly recognized 47 .…”

Oral SARS-CoV-2 Spike Protein Recombinant Yeast Candidate Prompts Specific Antibody and Gut Microbiota Reconstruction in Mice

“…“Long COVID” is the new evidence. The gut microbiome changes are linked to disease severity both in adult patients and young children with COVID-19 ( Yeoh et al, 2021 ; Nashed et al, 2022 ; Sun et al, 2022 ). Several gut commensals microbiota with known immunomodulatory potential were underrepresented in patients and remained low in samples collected up to 30 days after disease resolution.…”