Probiotics and prebiotics: potential prevention and therapeutic target for nutritional management of COVID-19?

Abstract

Scientists are working to identify prevention/treatment methods and clinical outcomes of Coronavirus Disease 2019 (COVID-19). Nutritional status and diet have a major impact on the COVID-19 health-disease process, mainly due to the bidirectional interaction between gut-lung axis. Individuals with inadequate nutritional status have a pre-existing imbalance in the gut microbiota and immunity as seen in obesity, diabetes, hypertension, or other chronic diseases. Communication between the gut microbiota and lungs or other organs and systems may trigger worse clinical outcomes in viral respiratory infections. Thus, this review addresses new insights into the use of probiotics and prebiotics as a preventive nutritional strategy in managing respiratory infections such as COVID-19 and highlighting their anti-inflammatory effects against the main signs and symptoms associated with COVID-19. The search for studies was performed through Pubmed, Cochrane Library, Scopus, and Web of Science databases; relevant clinical articles were included. Significant randomized clinical trials suggest that specific probiotics and/or prebiotics reduce diarrhoea, abdominal pain, vomiting, headache, cough, sore throat, fever, and viral infection complications such as acute respiratory distress syndrome. These beneficial effects are linked with modulation of the microbiota, products of microbial metabolism with antiviral activity, and immune regulatory properties of specific probiotics and prebiotics through of Treg cell production and function. There is a need to conduct clinical and pre-clinical trials to assess the effect of consuming these components together with the current therapies in COVID-19.

The Promising Role of Microbiome Therapy on Biomarkers of Inflammation and Oxidative Stress in Type 2 Diabetes: A Systematic and Narrative Review

“…In fact, probiotics have been shown to have a larger beneficial effect in inflammatory biomarker levels such as IL-6 and CRP as a measure of low-grade inflammation than even Angiotensin Receptors Blockers, omega-3, metformin, resveratrol, and vitamin D ( 235 ). These gut-microbiome modulating nutraceuticals have shown to serve also as immunomodulators leading to downregulation of the low-grade inflammation state ( 236 , 237 ), leading to an overall reduction or attenuation of COVID-19 related symptoms such as “diarrhea, abdominal pain, vomiting, headache, cough, sore throat, fever, and viral infection complications such as acute respiratory distress syndrome (ARDS)” ( 238 ). By close monitoring of potential interactions with diabetes and antiviral drugs, especially conserving that many antibiotics given during COVID-19 infection may further lead to gut microbiome dysbiosis ( 233 ), probiotics, along with pre- and synbiotics, may serve as therapeutic agents with low adverse event incidence for treatment of diabetics with COVID-19 ( 239 ).…”

Gut Microbiota Dynamics in Relation to Long-COVID-19 Syndrome: Role of Probiotics to Combat Psychiatric Complications

“…Probiotics and prebiotics are the two components in our diet that can affect the microbiome. Nutritional status and diet play a crucial role in COVID-19, predominantly owing to the bidirectional interaction between the lungs and the gut microbiota [ 146 ]. Figure 5 depicts the interactions between the human gut and lungs and the potential positive immune responses triggered by probiotics and prebiotics.…”

Current Status of Probiotics as Supplements in the Prevention and Treatment of Infectious Diseases

“…As acute lung injury-mediated lung dysbiosis has been demonstrated to be associated with blood-mediated modulation of the gut microbiota, coronavirus disease 2019 (COVID-19) may induce lung microbiota disruption, thus driving the imbalance of the gut microbiota ( Olaimat et al., 2020 ). By investigating the lung tissue of deceased COVID-19 patients, it was found that lung microbiome dysbiosis in severe COVID-19 patients was characterized by enrichment of bacteria that are primarily responsible for the highest rates of multidrug resistance and mortality; therefore, continuous monitoring of the lower respiratory tract microbiota is needed for prompt and personalized treatment ( Batista et al., 2021 ). The occupational health impact of respiratory infectious diseases is costly to the economy and the healthcare system.…”