ABSTRACT
Due to the alarming spread of bacterial resistance to conventional drugs, the sole use of antibiotics to fight lung infections in cystic fibrosis (CF) is not resolutive, and novel strategies to replace or complement the use of antibiotics are highly desirable. Among these strategies, the use of probiotics is emerging as a particularly attractive approach. Probiotic administration via the oral route has demonstrated an ability to improve lung function and to reduce infection and exacerbation rates in CF patients through mechanisms mainly attributable to the gut-lung axis. Nevertheless, some studies reported no beneficial effect of probiotic intake suggesting that there is margin for improvement of such innovative intervention in CF. The present review aims to address the rationale behind probiotic use in CF and discuss the hypothesis that nasal/aerosol administration of appropriate probiotic strains may help to exert a direct beneficial effect on the respiratory tract, increasing the effectiveness of probiotic interventions in CF patients.
ABSTRACT
Oral bacteriotherapy with SAB51 has been previously evidenced as support of standard care in treating patients hospitalized for SARS-CoV2 pneumonia and associated gastrointestinal symptoms leading to a significantly decreased risk of developing respiratory failure. This study aimed to compare the rate of mortality, the need for ICU hospitalization, and the length of hospitalization in patients with severe COVID-19 pneumonia who received the best available therapy in Italy (BAT) versus patients treated with BAT and supplemented with SLAB51. 200 adults (≥18 years) hospitalized from March 6 until April 26, 2020 with severe COVID-19 pneumonia and needing oxygen support were investigated. All patients received therapeutic regimens including hydroxychloroquine (200 mg twice a day for 7 days), azithromycin (500 mg once a day for 7 days), lopinavir–ritonavir (400/100 mg twice a day) or darunavir–cobicistat (800/150 mg once a day) for 14 days, and low molecular weight heparin. Out of the 200 patients, 112 received BAT without oral bacteriotherapy and 88 BAT with SLAB51. Crude mortality was 22%. Significantly higher mortality has been observed in the group of patients managed only with BAT (30%) to that treated with BAT plus SLAB51 (11%). In both groups, the highest mortality was registered for the combination of Tocilizumab and hydroxychloroquine and Tocilizumab. By multivariate analysis, the age >65 years, PCR >41.8 mg/L, Platelets <150.000 mmc, and CV events were associated with increased mortality risk. Overall results evidenced that oral bacteriotherapy with SLAB51 was an independent variable associated with a reduced risk for death.(Image presented) Death probability. Kaplan-Meier curves displaying Best Available therapy (BAT) versus BAT and oral bacteriotherapy.
ABSTRACT
Prolonged Fatigue, have been reported in many Covid-19 patients. There is a mounting suspicion that SARS-CoV2 acts as a catalyst for a condition known as chronic fatigue syndrome (CFS). Oral bacteriotherapy with SAB51 has been previously evidenced as support of standard care in ameliorating SARS-CoV2 pneumonia and associated gastrointestinal symptoms. This study aimed to evaluate the effectiveness of SLAB51 in preventing or contrasting CFS in patients hospitalized for SARS-CoV2 infection. 65 hospitalized adults with severe COVID-19 pneumonia have been enrolled. All patients received the best available therapy (BAT), including hydroxychloroquine, azithromycin, lopinavir–ritonavir, or daru-navir–cobicistat for 7 days, and low molecular weight heparin. In addition to the above treatments, 32 randomly chosen patients initiated oral bacteriotherapy with the multistrain probiotic SLAB51. Before starting therapies, a venous blood sample was collected to evaluate a complete set of biochemical features, including asparagine and lactate levels. A second blood sample has been collected after 7 days of treatment. At hospital discharge, patients were administered with the Fatigue Assessment Scale (FAS) according to that previously reported by De Vries and colleagues in 2004. Discharged subjects were asked to compile a second FAS relative to conditions experimented at admittance. A value of FAS≥21 was considered to assess the presence of chronic fatigue. At admittance, no significant differences were determined between the group of patients treated only with BAT and that additionally administered with oral bacteriotherapy for age, sex, the prevalence of Fatigue, and levels of biochemical features. Obtained results evidenced a significant increase of asparagine and lactate levels in the group of patients administered with SLAB51 after a 7 days treatment. In contrast, no significant differences were observed for the group of subjects receiving only BAT. Observed levels of asparagine and lactate were significantly higher in subjects administered with oral bacteriotherapy to those observed for the patients treated with BAT only. Notably, at hospital discharge, the group of patients receiving only BAT, presented a considerable increase in the proportion of subjects positive for CFS. In comparison, an invariant prevalence of CFS positive patients were observed in the group administered with SLAB51. Furthermore, a significant association between CFS development and the lack of oral bacteriotherapy supplementation has been observed. Obtained results strongly evidenced that oral bacteriotherapy could represent a promising therapeutic strategy in reducing fatigue and preventing CFS development above all in fragile subjects. Furthermore, our findings contribute to stress the importance of the modulation of gut microbiota in influencing the outcome of Covid-19 patients. (Figure Presented)
ABSTRACT
In the pandemic coronavirus disease 2019 (COVID-19) era, the need to use preventive-curative treatments is compelling. A series of non-pharmacological compounds, including oligo-elements, vitamins, nutraceuticals, and bacteriotherapy, might affect the risk of COVID-19, both reinforcing the immune system and improving the inflammation resolution during respiratory infections. Non-pharmacological remedies are very popular and usually have no relevant side effects. Bacterial and natural products may potentiate the immune system against respiratory viruses. Moreover, these compounds also exert antiinflammatory and antioxidant activity. Consequently, these non-chemical remedies could be prescribed to build up the immune defence and adequately treat the upper respiratory infection. In this way, natural compounds could be used to manage people in the pandemic COVID-19 era.
Subject(s)
COVID-19 , Pandemics , Dietary Supplements , Humans , SARS-CoV-2 , VitaminsABSTRACT
Background: Mounting evidence suggests SARS-CoV-2 may impact on host microbiota and gut inflammation, infecting intestinal epithelial cells. This possible link and its implications can be investigated by observing the effects of modulation of the microbial flora in patients with COVID-19. The aim of this study was to compare the rate of mortality, the need of ICU hospitalization and the length of hospitalization in patients with severe COVID-19 pneumonia who received the best available therapy (BAT) vs. patients treated with BAT and supplemented with oral bacteriotherapy. Methods: This retrospective, observational cohort study included 200 adults with severe COVID-19 pneumonia. All patients received therapeutic regimens including low molecular weight heparin plus one or more between hydroxychloroquine, azithromycin, antivirals, and Tocilizumab. Oral bacteriotherapy was used as complementary treatment. Results: Out of the 200 patients, 112 received BAT without oral bacteriotherapy, and 88 BAT with oral bacteriotherapy. Crude mortality was 22%. Eleven percent died in the group of patients treated with BAT plus oral bacteriotherapy vs. 30% subjects in the group of patients managed only with BAT (p < 0.001). By multivariate analysis, the age >65 years, CRP >41.8 mg/L, Platelets <150.000 mmc, and cardiovascular events were associated with the increased risk of mortality. Oral bacteriotherapy was an independent variable associated with a reduced risk for death. Despite large prospective trials are needed, this study highlights a possible role for oral bacteriotherapy in the management of patients hospitalized for COVID-19 pneumonia.
ABSTRACT
Background: Gastrointestinal disorders are frequent in COVID-19 and SARS-CoV-2 has been hypothesized to impact on host microbial flora and gut inflammation, infecting intestinal epithelial cells. Since there are currently no coded therapies or guidelines for treatment of COVID-19, this study aimed to evaluate the possible role of a specific oral bacteriotherapy as complementary therapeutic strategy to avoid the progression of COVID-19. Methods: We provide a report of 70 patients positive for COVID-19, hospitalized between March 9th and April 4th, 2020. All the patients had fever, required non-invasive oxygen therapy and presented a CT lung involvement on imaging more than 50%. Forty-two patients received hydroxychloroquine, antibiotics, and tocilizumab, alone or in combination. A second group of 28 subjects received the same therapy added with oral bacteriotherapy, using a multistrain formulation. Results: The two cohorts of patients were comparable for age, sex, laboratory values, concomitant pathologies, and the modality of oxygen support. Within 72 h, nearly all patients treated with bacteriotherapy showed remission of diarrhea and other symptoms as compared to less than half of the not supplemented group. The estimated risk of developing respiratory failure was eight-fold lower in patients receiving oral bacteriotherapy. Both the prevalence of patients transferred to ICU and mortality were higher among the patients not treated with oral bacteriotherapy. Conclusions: A specific bacterial formulation showed a significant ameliorating impact on the clinical conditions of patients positive for SARS-CoV-2 infection. These results also stress the importance of the gut-lung axis in controlling the COVID-19 disease.