Rapid resolution of COVID-19 after faecal microbiota transplantation

Biliński, Jarosław; Winter, Katarzyna; Jasiński, Marcin; Szczęś, Anna; Bilinska, Natalia; Mullish, Benjamin H.; Małecka‐Panas, Ewa; Basak, Grzegorz W.

doi:10.1136/gutjnl-2021-325010

Cited by 51 publications

(55 citation statements)

References 10 publications

(8 reference statements)

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“…Given the proposed role of gut microbiota in the abnormal activation of immune responses in the COVID-19, FMT can potentially be explored as a therapeutic strategy. A recent case report ( 85 ) described two patients with rapid resolution of COVID-19 after FMT was undertaken to treat concomitant C. difficile infection. However strong may be the hypothesis and surrounding speculations, FMT should not presently be recommended as a therapy against COVID-19 due to the scarcity of large-scale studies.…”

Section: Therapeutic Potential Of Gut Microbiome For Covid-19mentioning

confidence: 99%

Role of Gut Microbiome in COVID-19: An Insight Into Pathogenesis and Therapeutic Potential

et al. 2021

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Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulted in an unprecedented global crisis. Although primarily a respiratory illness, dysregulated immune responses may lead to multi-organ dysfunction. Prior data showed that the resident microbial communities of gastrointestinal and respiratory tracts act as modulators of local and systemic inflammatory activity (the gut–lung axis). Evolving evidence now signals an alteration in the gut microbiome, brought upon either by cytokines from the infected respiratory tract or from direct infection of the gut, or both. Dysbiosis leads to a “leaky gut”. The intestinal permeability then allows access to bacterial products and toxins into the circulatory system and further exacerbates the systemic inflammatory response. In this review, we discuss the available data related to the role of the gut microbiome in the development and progression of COVID-19. We provide mechanistic insights into early data with a focus on immunological crosstalk and the microbiome’s potential as a biomarker and therapeutic target.

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Section: Therapeutic Potential Of Gut Microbiome For Covid-19mentioning

confidence: 99%

Role of Gut Microbiome in COVID-19: An Insight Into Pathogenesis and Therapeutic Potential

et al. 2021

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“…In our recent study, we identified the genus Lachnospiraceae_NK4A136_group (phylum Firmicutes) as a food allergy-associated bacteria [41], and a recent study pointed to the existence of gut-associated bacteria, such as the family Lachnospiraceae in the lung microbiota of patients with ARDS [90]. Interestingly, recent studies introduced the therapeutic potential of fecal microbiota transplantation (FMT) for recurrent Clostridium difficile infection patients with COVID-19 [91,92]. In addition, a clinical trial (NCT04824222) to assess the impact of FMT on reducing the risk of disease progression as a supplement to standard COVID-19 treatment is ongoing [92].…”

Section: Hypothesis: Potential Impact Of Phototherapy With Full-spectrum Light On the Covid-19 Pandemicmentioning

confidence: 99%

“…Interestingly, recent studies introduced the therapeutic potential of fecal microbiota transplantation (FMT) for recurrent Clostridium difficile infection patients with COVID-19 [91,92]. In addition, a clinical trial (NCT04824222) to assess the impact of FMT on reducing the risk of disease progression as a supplement to standard COVID-19 treatment is ongoing [92]. On the other hand, Parabacteroides goldsteinii (phylum Bacteroidetes) was identified as a beneficial bacterial species enriched by phototherapy with full-spectrum light [41].…”

Section: Hypothesis: Potential Impact Of Phototherapy With Full-spectrum Light On the Covid-19 Pandemicmentioning

confidence: 99%

“…Lachnospiraceae in the lung microbiota of patients with ARDS [90]. Interestingly, recent studies introduced the therapeutic potential of fecal microbiota transplantation (FMT) for recurrent Clostridium difficile infection patients with COVID-19 [91,92]. In addition, a clinical trial (NCT04824222) to assess the impact of FMT on reducing the risk of disease progression as a supplement to standard COVID-19 treatment is ongoing [92].…”

Section: Int J Environ Res Public Health 2021 18 X For Peer Review 7 Of 16mentioning

confidence: 99%

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Sunlight Exposure and Phototherapy: Perspectives for Healthy Aging in an Era of COVID-19

Nakano

Chiang

Chen

et al. 2021

IJERPH

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Most humans depend on sunlight exposure to satisfy their requirements for vitamin D3. However, the destruction of the ozone layer in the past few decades has increased the risk of skin aging and wrinkling caused by excessive exposure to ultraviolet (UV) radiation, which may also promote the risk of skin cancer development. The promotion of public health recommendations to avoid sunlight exposure would reduce the risk of skin cancer, but it would also enhance the risk of vitamin D3 insufficiency/deficiency, which may cause disease development and progression. In addition, the ongoing global COVID-19 pandemic may further reduce sunlight exposure due to stay-at-home policies, resulting in difficulty in active and healthy aging. In this review article, we performed a literature search in PubMed and provided an overview of basic and clinical data regarding the impact of sunlight exposure and vitamin D3 on public health. We also discuss the potential mechanisms and clinical value of phototherapy with a full-spectrum light (notably blue, red, and near-infrared light) as an alternative to sunlight exposure, which may contribute to combating COVID-19 and promoting active and healthy aging in current aged/superaged societies.

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“…Another way to influence the gut microbiome more radically is faecal microbiota transplant (FMT). Two cases were reported, from an 80-and a 19-year-old man, who received an FMT to treat a Clostridioides difficile infection (CDI) [89]. Both had severe comorbidities.…”

Section: Targeting the Gut Microbiome As Adjunctive Therapy For Covid-19mentioning

confidence: 99%

Is the Gut Microbiome a Target for Adjuvant Treatment of COVID-19?

Hilpert

2021

Biologics

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High expression of the transmembrane protein angiotensin I converting enzyme 2 (ACE2), more than 100-times higher as in the lung, and transmembrane serine protease 2 (TMPRSS2) in the gastrointestinal tract leads to infection with SARS-CoV-2. According to meta-analysis data, 9.8–20% of COVID-19 patients experience gastrointestinal symptoms, where diarrhoea is the most frequent, and about 50% shed viruses with high titre through their faeces, where a first faecal transmission was reported. Furthermore, gut inflammation, intestinal damage, and weakening of the gut mucosal integrity that leads to increased permeability has been shown in different studies for COVID-19 patients. This can lead to increased inflammation and bacteraemia. Low mucosal integrity combined with low intestinal damage is a good predictor for disease progression and submission to the intensive care unit (ICU). Several pilot studies have shown that the gut microbiome of COVID-19 patients is changed, microbial richness and diversity were lower, and opportunistic pathogens that can cause bacteraemia were enriched compared to a healthy control group. In a large proportion of these patients, dysbiosis was not resolved at discharge from the hospital and one study showed dysbiosis is still present after 3 months post COVID-19. Consequently, there might be a link between dysbiosis of the gut microbiome in COVID-19 patients and chronic COVID-19 syndrome (CCS). Various clinical trials are investigating the benefit of probiotics for acute COVID-19 patients, the majority of which have not reported results yet. However, two clinical trials have shown that a certain combination of probiotics is beneficial and safe for acute COVID-19 patients. Mortality was 11% for the probiotic treatment group, and 22% for the control group. Furthermore, for the probiotic group, symptoms cleared faster, and an 8-fold decreased risk of developing a respiratory failure was calculated. In conclusion, evidence is arising that inflammation, increased permeability, and microbiome dysbiosis in the gut occur in COVID-19 patients and thus provide new targets for adjuvant treatments of acute and chronic COVID-19. More research in this area is needed.

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Rapid resolution of COVID-19 after faecal microbiota transplantation

Abstract: Figure 1 Timeline of the procedures performed in patients with CDI, which coincidentally occurred during COVID-19 early stage infection. Created with BioRender.com. CDI, Clostridioides difficile infection; ESBL, extended-spectrum beta-lactamase, FMT, faecal microbiota transplant.

Cited by 51 publications

References 10 publications

Role of Gut Microbiome in COVID-19: An Insight Into Pathogenesis and Therapeutic Potential

Role of Gut Microbiome in COVID-19: An Insight Into Pathogenesis and Therapeutic Potential

Sunlight Exposure and Phototherapy: Perspectives for Healthy Aging in an Era of COVID-19

Is the Gut Microbiome a Target for Adjuvant Treatment of COVID-19?

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