SARS-CoV-2 and Prevotella spp.: friend or foe? A systematic literature review

Abstract

During this global pandemic of the COVID-19 disease, a lot of information has arisen in the media and online without scientific validation, and among these is the possibility that this disease could be aggravated by a secondary bacterial infection such as Prevotella, as well as the interest or not in using azithromycin, a potentially active antimicrobial agent. The aim of this study was to carry out a systematic literature review, to prove or disprove these allegations by scientific arguments. The search included Medline, PubMed, and Pubtator Central databases for English-language articles published 1999–2021. After removing duplicates, a total of final eligible studies (n=149) were selected. There were more articles showing an increase of Prevotella abundance in the presence of viral infection like that related to Human Immunodeficiency Virus (HIV), Papillomavirus (HPV), Herpesviridae and respiratory virus, highlighting differences according to methodologies and patient groups. The arguments for or against the use of azithromycin are stated in light of the results of the literature, showing the role of intercurrent factors, such as age, drug consumption, the presence of cancer or periodontal diseases. However, clinical trials are lacking to prove the direct link between the presence of Prevotella spp. and a worsening of COVID-19, mainly those using azithromycin alone in this indication.

Dynamic changes of Bacterial Microbiomes in Oropharynx during Infection and Recovery of COVID-19 Omicron Variant

“…And it also closely related to localized infection of ear and nose [ 27 , 28 ], inflammatory periodontitis [ 29 , 30 ], pulmonary infection [ 31 , 32 ], gastrointestinal infection [ 33 , 34 ] and some autoimmune diseases. Moreover, immunological interactions between Prevotella and viruses usually inducing an increase of pro-inflammatory responses [ 35 ]. Virulence factors including lipopolysaccharide [ 36 , 37 ], fimbriae [ 38 ], hemolysin [ 39 ] and adhesin [ 40 ] were found in Prevotella , which can promote its pathogenicity and survival in the host.…”

Longitudinal study across SARS-CoV-2 variants identifies transcriptionally active microbes (TAMs) associated with Delta severity

“…Additionally, Prevotella has been enriched in other respiratory infections, including pulmonary empyema, lung abscess, inhalation pneumonia, chronic otitis, and sinusitis. 34 , 35 , 36 Prevotella has also been identified as one of the most prevalent bacterial populations in the oropharynx of HIV-positive patients. During COVID-19, the prevalence of Prevotella has been found to be higher in infected patients.…”

肠道菌群与 Covid-2019 之间的因果关系：一项孟德尔随机化研究

“…Our study showed that the abundance of Prevotella was positively correlated with hospitalized COVID-19. The increased Prevotella suggests the presence of a large number of viral infections, such as human immunodeficiency virus (HIV), papillomavirus (HPV), herpesvirus, and respiratory viruses [30]. Intriguingly, the increased abundance ofRuminococcus gnavus could not only be found in the respiratory tract, but also be reported to coincide with inflammatory bowel disease [31] [32] [33].…”