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Topics in Antiviral Medicine ; 29(1):69-70, 2021.
Article in English | EMBASE | ID: covidwho-1250818


Background: SARS-CoV2 can infect enterocytes, and plasma cells and lymphocytes infiltrate the GI tract. In HIV, increased intestinal permeability and the ensuing microbial translocation are thought to contribute to systemic inflammation. We hypothesize that severe COVID-19 is associated with increased intestinal permeability, leading to microbial translocation and systemic inflammation. Methods: Serum/plasma samples were obtained from participants enrolled in a longitudinal COVID-19 study. Participants had Mild (outpatient), Moderate (inpatient but not requiring Intensive Care Unit (ICU) level care or mechanical ventilation), or Severe (inpatient requiring ICU level care and mechanical ventilation or ECMO) COVID-19. Intestinal fatty acid binding protein (iFABP), lipopolysaccharide binding protein (LBP), and soluble CD14 (sCD14) were measured by ELISA. Student's t-tests were used for between group comparisons, and paired t-tests were used for within group comparisons. Results: Participants with Moderate and Severe COVID-19 presentations were older compared to the Mild group (p<0.001) (Mild: 42.2 years (range: 20-63 years), Moderate: 64.2 years (range: 33-97 years);Severe: 61.9 years (range: 32-86 years)). The Severe group had a greater proportion of men (69% vs 36%) than women and a greater proportion of black/African Americans (27% vs 6%) than whites versus the Mild group. iFABP, LBP, and sCD14 levels were significantly higher in participants with Moderate or Severe disease compared to Mild disease (Table 1), with no significant differences between Moderate and Severe groups. Among the 65 participants with samples from two timepoints (mean separation of 24.3+/-22.4 days), sCD14, iFABP, and LBP did not change significantly. Conclusion: Levels of biomarkers of enterocyte turnover (iFABP), microbial translocation (LBP), and lipopolysaccharide-induced monocyte activation (sCD14) were increased in patients with Moderate and Severe COVID-19 compared to Mild COVID-19. Whether interventions that improve gut health will attenuate the cytokine storm that precipitates Severe COVID-19 needs further study.