RESUMEN
A multidisciplinary approach in the treatment of COVID-19 warrants close attention to the role of the intestinal microbiome in terms of disease pathology, disruption of local and systemic homeostasis, and possible treatment strategies. Dysbiotic disorders affect the immune system on the level of postvaccination immunity, influencing the likelihood and severity of SARS-CoV-2 infection, indicating the importance of intestinal microbiota in the prevention of complications and risk reduction. The fundamental factor in the stability of the intestinal microflora is a diet that includes regular consumption of probiotic foods, which support healthy microbiota. Restoration of damaged intestinal microbiota in cases of dysbiosis requires specific supplements and foods, which vary significantly for each symbiont. In clinical practice, the most appropriate approach is a differentiated one, taking into account the severity of the dysbiotic condition, comorbidities, and the age of the patients. A bacteria consortium of the human microbiome is the basis for a bioprobiotics complex with targeted action. The translational benefits of such therapy in most common COVID-19 syndromes are in detail presented in this chapter. We discuss the role of SARS-CoV-2 infection on the microbiota, as well as pathogenetic mechanisms of microbiota disruption, local and systemic influencing factors, and treatment strategies. © 2023 Elsevier Inc. All rights reserved.
RESUMEN
Background: Autopsies on COVID-19 deceased patients have many limitations due to necessary epidemiologic and preventative measures. The ongoing pandemic has caused a significant strain on healthcare systems and is being extensively studied around the world. Clinical data does not always corelate with post-mortem findings. The goal of our study was to find pathognomonic factors associated with COVID-19 mortality in 100 post-mortem full body autopsies. Materials and Methods: Following necessary safety protocol, we performed 100 autopsies on patients who were diagnosed with COVID-19 related death. The macroscopic and microscopic pathologies were evaluated along with clinical and laboratory findings. Results: Extensive coagulopathic changes are seen throughout the bodies of diseased patients. Diffuse alveolar damage is pathognomonic of COVID-19 viral pneumonia, and is the leading cause of lethal outcome in younger patients. Extrapulmonary pathology is predominantly seen in the liver and spleen. Intravascular thrombosis is often widespread and signs of septic shock are often present. Conclusion: The described pathological manifestations of COVID-19 in deceased patients are an insight into the main mechanisms of SARS-CoV-2 associated lethal outcome. The disease bears no obvious bias in severity, but seems to be more severe in some patients, hinting at genetic or epigenetic factors at play.