ABSTRACT
Purpose Increasing evidence indicates a possible relationship between the pathogenesis of COVID-19 and the nasopharyngeal microbiota. This study aimed to compare the nasopharyngeal microbiota of COVID-19 patients with different disease severity. Methods & Materials A comparative study was performed on patients classified into four groups according to their disease severity. A total of 26 patients were recruited for each of the following study groups. Group 1 (G1): patients with a confirmatory diagnosis of SARS-CoV-2 and hospitalized in the ICU. Group 2 (G2): patients with a confirmatory diagnosis of SARS-CoV-2 and hospitalized in regular hospitalization wards. Group 3 (G3): patients with a confirmatory diagnosis of SARS-CoV-2 who were not hospitalized and had mild or no symptoms. Group 4 (G4): healthy patients with a negative result for SARS-CoV-2. The diagnosis of SARS-CoV-2 was performed by reverse-transcriptase polymerase chain reaction (RT-PCR). The nasopharyngeal microbiota was characterized using polymerase chain reaction (PCR) targeting 13 representative bacteria genus. Results The detection of some bacteria genus was significantly more frequent in the hospitalized groups compared to healthy subjects. This is the case of Lactobacillus with 96.15% in G1, 96.15% in G2, 23.08% in G3 and 15.38% in G4. Similarly, Prevotella presented 96.15% in G1, 80.77 in G2, 0.00% in G3 and 19.23% in G4. Veilonella, Bacteroidetes and Firmicutes presented a similar prevalence. On the other hand, the detection of Eubacterium was more frequent among asymptomatic and healthy subjects, with 3.85% in G1, 19.23% in G2, 50.00% in G3 and 30.77% in G4. The relative abundance of the bacteria was evaluated and Lactobacillus and Veilonella were predominant in both of the hospitalized groups (G1 and G2). On the other hand, Actinobacteria and Eubacterium were predominant in the asymptomatic and healthy groups (G3 and G4) Conclusion In conclusion a unique nasopharyngeal microbiota profile was found in COVID-19 patients with different disease severity. Lactobacillus, Prevotella, Veilonella, Bacteroidetes and Firmicutes were the predominant bacteria genus in critical and hospitalized patients. While. Eubacterium and Actinobacteria were predominant in the groups of asymptomatic and healthy subjects. Further longitudinal studies are required to determine the prognostic role of the nasopharyngeal microbiota.
ABSTRACT
INTRODUCTION: COVID-19 affects the liver, causing alteration in liver biochemistry tests such as aspartate transferase (AST), alanine transferase (ALT), alkaline phosphatase (ALP), total bilirubin and albumin. OBJECTIVE: To determine the prevalence of alteration in liver functions tests and associated factors for severity among Peruvian COVID-19 patients. MATERIALS AND METHODS: A descriptive, retrospective and cross-sectional study was performed in 4 public hospitals in Peru. Patients admitted to hospitalization wards and intensive care units with a diagnosis COVID-19 were enrolled. The evaluation of AST, ALT, ALP, totalbilirubin and albumin was performed. Associations with demographic and medical data were assessed. RESULTS: 1,100 patients were enrolled, of which 81.7% had altered liver function tests. Only 2.8% of the patients had cirrhosis and 2.1% hepatitis B/C virus. AST and ALT were altered at admission in 64.7% and 63.7%, of the patients respectively. Factors associated with liver injury were: being female OR=0.53 (95% CI: 0.39-0.73;p<0.01), dyslipidemia OR=1.72 (95% CI: 1.10-2.70;p=0.01), previous medication OR=1.56 (95% CI: 1.12 -2.16, p<0.01) and fever OR=1.43 (95% CI: 1.03-1.199, p=0.03). Disease severity was associated with levels of AST and ALT (p<0.01). Patients taking self-medication OR=1.56 (95% CI: 1.12-2.16;p<0.01) and paracetamol OR= 1.41 (95% CI:1.01-1.98;p=0.04) had higher risk of liver injury. Meanwhile, corticosteroids OR=0.55 (95% CI: 0.38-0.78;p<0.01) and enoxaparin OR=0.53 (95% CI: 0.35- 0.81;p<0.01) were protective factors. CONCLUSIONS: Peruvian patients with COVID-19 presented high prevalence of alteration in liver function tests, high levels of AST and ALT were related to disease severity.