Probiotics in the Management of Mental and Gastrointestinal Post-COVID Symptomes

Abstract

Patients with “post-COVID” syndrome manifest with a variety of signs and symptoms that continue/develop after acute COVID-19. Among the most common are gastrointestinal (GI) and mental symptoms. The reason for symptom occurrence lies in the SARS-CoV-2 capability of binding to exact receptors, among other angiotensin converting enzyme 2 (ACE2) receptors in gastrointestinal lining and neuropilin-1 (NRP-1) in the nervous system, which leads to loss of gastrointestinal and blood-brain barriers integrity and function. The data are mounting that SARS-CoV-2 can trigger systemic inflammation and lead to disruption of gut-brain axis (GBA) and the development of disorders of gut brain interaction (DGBIs). Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are the most common DGBIs syndromes. On the other hand, emotional disorders have also been demonstrated as DGBIs. Currently, there are no official recommendations or recommended procedures for the use of probiotics in patients with COVID-19. However, it can be assumed that many doctors, pharmacists, and patients will want to use a probiotic in the treatment of this disease. In such cases, strains with documented activity should be used. There is a constant need to plan and conduct new trials on the role of probiotics and verify their clinical efficacy for counteracting the negative consequences of COVID-19 pandemic. Quality control is another important but often neglected aspect in trials utilizing probiotics in various clinical entities. It determines the safety and efficacy of probiotics, which is of utmost importance in patients with post-acute COVID-19 syndrome.

Promising Markers of Inflammatory and Gut Dysbiosis in Patients with Post-COVID-19 Syndrome

“…This indicates the need for laboratory tests to identify the features of dysbiosis after the disease with subsequent correction. The impact of diet, nutrients, and probiotics in reducing the severity of COVID-19 infection has been suggested [ 11 , 39 , 40 ]. One of the promising measures aimed at correcting the microbiota is a complex phage therapy, which has proven itself in a pilot study with the decrease of Bacteroides fragilis / Faecalibacterium prausnitzii ratio of anaerobic dysbiosis and no side effects in post-COVID-19 rehabilitation and in chronically critically ill patients [ 15 , 41 ].…”

The Role of Emotional Eating as Relief Mechanism from Psychological Distress and its Impact on Overall Wellbeing

“…Finally, a recently emerging area of using microbial-based psychobiotics, which are made of using specific probiotic strains exerting beneficial effects on the brain function, may help in modulation response to stressful situations. An example of bacteria with psychobiotic properties are predominantly Lactobacillus and Bifidobacterium genus, due to their ability to produce neuroactive substances such as γ-aminobutyric acid (GABA) and serotonin, which exert effects on the brain-gut axis [35] thus reduce severity of symptoms of psychiatric illness [36]. To date, these preparations have shown to have therapeutic potential in addressing symptoms of mental health disorders like depression, anxiety, and PTSD, while encompassing changes in mood, personality dimensions, and sleep quality.…”

The Microbiota–Gut–Brain Axis in Psychiatric Disorders

“…However, the study of Slykerman and Li [ 63 ] covering nurses working during the 2020 pandemic year in New Zealand who took the probiotic Lactobacillus rhamnosus HN001 probiotic for 12 weeks have not revealed significant differences in recognized stress or signs of viral disease. It should also be noted that there are some limitations in probiotic supplementation; for example, they are not recommended for immunocompromised patients treated with corticosteroids [ 64 ]. Although there are no global approved ordinances on probiotic supplementation of probiotics in patients with COVID-19, probiotics could potentially find application in the prevention and complementary therapy of this disease.…”