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Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19.
Yeoh, Yun Kit; Zuo, Tao; Lui, Grace Chung-Yan; Zhang, Fen; Liu, Qin; Li, Amy Yl; Chung, Arthur Ck; Cheung, Chun Pan; Tso, Eugene Yk; Fung, Kitty Sc; Chan, Veronica; Ling, Lowell; Joynt, Gavin; Hui, David Shu-Cheong; Chow, Kai Ming; Ng, Susanna So Shan; Li, Timothy Chun-Man; Ng, Rita Wy; Yip, Terry Cf; Wong, Grace Lai-Hung; Chan, Francis Kl; Wong, Chun Kwok; Chan, Paul Ks; Ng, Siew C.
  • Yeoh YK; Department of Microbiology, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Zuo T; Center for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Lui GC; Center for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Zhang F; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Liu Q; State Key Laboratory for digestive disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Li AY; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Chung AC; Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Cheung CP; Center for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Tso EY; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Fung KS; State Key Laboratory for digestive disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Chan V; Center for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Ling L; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Joynt G; State Key Laboratory for digestive disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Hui DS; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Chow KM; Center for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Ng SSS; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Li TC; State Key Laboratory for digestive disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Ng RW; Center for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Yip TC; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Wong GL; State Key Laboratory for digestive disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Chan FK; Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Hong Kong.
  • Wong CK; Department of Pathology, United Christian Hospital, Kwun Tong, Hong Kong.
  • Chan PK; Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Hong Kong.
  • Ng SC; Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
Gut ; 70(4): 698-706, 2021 04.
Article in English | MEDLINE | ID: covidwho-1024254
ABSTRACT

OBJECTIVE:

Although COVID-19 is primarily a respiratory illness, there is mounting evidence suggesting that the GI tract is involved in this disease. We investigated whether the gut microbiome is linked to disease severity in patients with COVID-19, and whether perturbations in microbiome composition, if any, resolve with clearance of the SARS-CoV-2 virus.

METHODS:

In this two-hospital cohort study, we obtained blood, stool and patient records from 100 patients with laboratory-confirmed SARS-CoV-2 infection. Serial stool samples were collected from 27 of the 100 patients up to 30 days after clearance of SARS-CoV-2. Gut microbiome compositions were characterised by shotgun sequencing total DNA extracted from stools. Concentrations of inflammatory cytokines and blood markers were measured from plasma.

RESULTS:

Gut microbiome composition was significantly altered in patients with COVID-19 compared with non-COVID-19 individuals irrespective of whether patients had received medication (p<0.01). Several gut commensals with known immunomodulatory potential such as Faecalibacterium prausnitzii, Eubacterium rectale and bifidobacteria were underrepresented in patients and remained low in samples collected up to 30 days after disease resolution. Moreover, this perturbed composition exhibited stratification with disease severity concordant with elevated concentrations of inflammatory cytokines and blood markers such as C reactive protein, lactate dehydrogenase, aspartate aminotransferase and gamma-glutamyl transferase.

CONCLUSION:

Associations between gut microbiota composition, levels of cytokines and inflammatory markers in patients with COVID-19 suggest that the gut microbiome is involved in the magnitude of COVID-19 severity possibly via modulating host immune responses. Furthermore, the gut microbiota dysbiosis after disease resolution could contribute to persistent symptoms, highlighting a need to understand how gut microorganisms are involved in inflammation and COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Bacteria / Gastrointestinal Tract / Dysbiosis / Gastrointestinal Microbiome / SARS-CoV-2 / COVID-19 / Immunity Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: Gut Year: 2021 Document Type: Article Affiliation country: Gutjnl-2020-323020

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Bacteria / Gastrointestinal Tract / Dysbiosis / Gastrointestinal Microbiome / SARS-CoV-2 / COVID-19 / Immunity Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: Gut Year: 2021 Document Type: Article Affiliation country: Gutjnl-2020-323020