Targeting Microbiome: An Alternative Strategy for Fighting SARS-CoV-2 Infection

Spagnolello, Ornella; Pinacchio, Claudia; Santinelli, Letizia; Vassalini, Paolo; Innocenti, Giuseppe Pietro; Girolamo, Gabriella De; Fabris, Silvia; Giovanetti, Marta; Angeletti, Silvia; Russo, Alessandro; Mastroianni, Claudio Maria; Ciccozzi, Massimo; Ceccarelli, Giancarlo; d’Ettorre, Gabriella

doi:10.1159/000515344

Cited by 23 publications

(14 citation statements)

References 69 publications

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“…There are many important observations about the role of the gut microbiota during SARS-CoV-2 infection. The gut microbiota of COVID-19 patients is characterized by enrichment of opportunistic pathogens and alterations in gut cells also in the absence of gastrointestinal manifestations [ 19 , 25 , 26 ]. Of interest, these alterations were observed after hospitalization; however, the administration of broad-spectrum antibiotics is the major determinant for intestinal colonization by MDR pathogens.…”

Section: Discussionmentioning

confidence: 99%

Multidrug-resistant Acinetobacter baumannii infections in COVID-19 patients hospitalized in intensive care unit

et al. 2021

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Objectives Superinfections in patients hospitalized in intensive care unit (ICU) are an important and challenging complication, also in COVID-19. However, no definitive data are available about the role of multidrug-resistant Acinetobacter baumannii (MDR-AB) in COVID-19. Methods This was a single-center, cross-sectional study including patients with MDR-AB infections admitted to ICU with or without COVID-19, between January 2019 and January 2021. The primary objective of the study was to evaluate risk factor for MDR-AB infections in ICU patients hospitalized for COVID-19 or other etiology. The secondary endpoints were 30-days mortality in all study population and risk factors associated with development of bloodstream infection (BSI). Results During the study period 32 adults with COVID-19 were enrolled and compared with 115 patients admitted in the same ICU for other reasons. We observed a total of 114 deaths, with a survival rate of 29.3%: 18.8% in COVID-19 and 32.2% in control group. Relative risk for MDR-AB infection in COVID-19 showed that serum lactate levels mmol/l > 2, Acinetobacter baumannii colonization, BSI and steroid therapy were observed more frequently in COVID-19 patients. Cox regression analysis showed that serum lactate levels > 2 mmol/l, Acinetobacter baumannii colonization, BSI, and steroid therapy were associated with 30-days mortality. Finally, patients with COVID-19, white blood cells count > 11,000 mm3, serum lactate levels > 2 mmol/l, infections at time of ICU admission, Acinetobacter baumannii colonization, and steroid therapy were independently associated with development of BSI. Conclusions Our data highlight the impact of BSI on outcome, the role of Acinetobacter baumannii colonization and the use of steroids on the risk to develop MDR-AB infections also during COVID-19.

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Section: Discussionmentioning

confidence: 99%

Multidrug-resistant Acinetobacter baumannii infections in COVID-19 patients hospitalized in intensive care unit

et al. 2021

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“…Gut microbiota modulation with probiotics seem to affect the inflammatory storm of COVID-19 and to directly counteract replication of SARS-CoV-2 [ 104 ]. Thus, GM re-modulation via postbiotics can be crucial in preventing SARS-CoV-2 infection in predisposed humans [ 105 ].…”

Section: Resultsmentioning

confidence: 99%

From Pre- and Probiotics to Post-Biotics: A Narrative Review

Scarpellini

Rinninella

Basilico³

et al. 2021

IJERPH

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Background and aims: gut microbiota (GM) is a complex ecosystem containing bacteria, viruses, fungi, and yeasts. It has several functions in the human body ranging from immunomodulation to metabolic. GM derangement is called dysbiosis and is involved in several host diseases. Pre-, probiotics, and symbiotics (PRE-PRO-SYMB) have been extensively developed and studied for GM re-modulation. Herein, we review the literature data regarding the new concept of postbiotics, starting from PRE-PRO-SYMB. Methods: we conducted a search on the main medical databases for original articles, reviews, meta-analyses, randomized clinical trials, and case series using the following keywords and acronyms and their associations: gut microbiota, prebiotics, probiotics, symbiotic, and postbiotics. Results: postbiotics account for PRO components and metabolic products able to beneficially affect host health and GM. The deeper the knowledge about them, the greater their possible uses: the prevention and treatment of atopic, respiratory tract, and inflammatory bowel diseases. Conclusions: better knowledge about postbiotics can be useful for the prevention and treatment of several human body diseases, alone or as an add-on to PRE-PRO-SYMB.

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“…In conclusion, a growing body of evidence suggests that dysbiosis and modification of metabolic processes due to the imbalance of the intestinal flora, observed in patients infected by SARS-CoV-2, may play a key role in determining the severity of the COVID-19, including neuropsychological, psychiatric and long-term disorders (51)(52)(53)(54)(55). Given the significant impact of SARS-CoV-2 on host's microbiota and the current lack of effective therapeutic options, a possible role of oral bacteriotherapy has been hypothesized, as complementary therapeutic strategy to fight the pathophysiological changes due to SARS-CoV-2 and the COVID-19 related damages (11)(12)(13)(14)(15)(56)(57)(58)(59)(60)(61)(62).…”

Section: Discussionmentioning

confidence: 97%

Oral Bacteriotherapy Reduces the Occurrence of Chronic Fatigue in COVID-19 Patients

et al. 2022

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Long COVID refers to patients with symptoms as fatigue, “brain fog,” pain, suggesting the chronic involvement of the central nervous system (CNS) in COVID-19. The supplementation with probiotic (OB) would have a positive effect on metabolic homeostasis, negatively impacting the occurrence of symptoms related to the CNS after hospital discharge. On a total of 58 patients hospitalized for COVID-19, 24 (41.4%) received OB during hospitalization (OB+) while 34 (58.6%) taken only the standard treatment (OB–). Serum metabolomic profiling of patients has been performed at both hospital acceptance (T0) and discharge (T1). Six months after discharge, fatigue perceived by participants was assessed by administrating the Fatigue Assessment Scale. 70.7% of participants reported fatigue while 29.3% were negative for such condition. The OB+ group showed a significantly lower proportion of subjects reporting fatigue than the OB– one (p < 0.01). Furthermore, OB+ subjects were characterized by significantly increased concentrations of serum Arginine, Asparagine, Lactate opposite to lower levels of 3-Hydroxyisobutirate than those not treated with probiotics. Our results strongly suggest that in COVID-19, the administration of probiotics during hospitalization may prevent the development of chronic fatigue by impacting key metabolites involved in the utilization of glucose as well as in energy pathways.

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Targeting Microbiome: An Alternative Strategy for Fighting SARS-CoV-2 Infection

Cited by 23 publications

References 69 publications

Multidrug-resistant Acinetobacter baumannii infections in COVID-19 patients hospitalized in intensive care unit

Multidrug-resistant Acinetobacter baumannii infections in COVID-19 patients hospitalized in intensive care unit

From Pre- and Probiotics to Post-Biotics: A Narrative Review

Oral Bacteriotherapy Reduces the Occurrence of Chronic Fatigue in COVID-19 Patients

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