Considerations for Gut Microbiota and Probiotics in Patients with Diabetes Amidst the Covid-19 Pandemic: A Narrative Review.
Endocr Pract
; 26(10): 1186-1195, 2020 Oct.
Article
in English
| MEDLINE | ID: covidwho-1067864
ABSTRACT
OBJECTIVE:
To review data implicating microbiota influences on Coronavirus Disease 2019 (COVID-19) in patients with diabetes.METHODS:
Primary literature review included topics "COVID-19," "SARS," "MERS," "gut micro-biota," "probiotics," "immune system," "ACE2," and "metformin."RESULTS:
Diabetes was prevalent (~11%) among COVID-19 patients and associated with increased mortality (about 3-fold) compared to patients without diabetes. COVID-19 could be associated with worsening diabetes control and new diabetes diagnosis that could be linked to high expression of angiotensin-converting enzyme 2 (ACE2) receptors (coronavirus point of entry into the host) in the endocrine pancreas. A pre-existing gut microbiota imbalance (dysbiosis) could contribute to COVID-19-related complications in patients with diabetes. The COVID-19 virus was found in fecal samples (~55%), persisted for about 5 weeks, and could be associated with diarrhea, suggesting a role for gut dysbiosis. ACE2 expressed on enterocytes and colonocytes could serve as an alternative route for acquiring COVID-19. Experimental models proposed some probiotics, including Lactobacillus casei, L. plantarum, and L. salivarius, as vectors for delivering or enhancing efficacy of anti-coronavirus vaccines. These Lactobacillus probiotics were also beneficial for diabetes. The potential mechanisms for interconnections between coronavirus, diabetes, and gut microbiota could be related to the immune system, ACE2 pathway, and metformin treatment. There were suggestions but no proof supporting probiotics benefits for COVID-19 infection.CONCLUSION:
The data suggested that the host environment including the gut microbiota could play a role for COVID-19 in patients with diabetes. It is a challenge to the scientific community to investigate the beneficial potential of the gut microbiota for strengthening host defense against coronavirus in patients with diabetes.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Probiotics
/
Diabetes Mellitus
/
Gastrointestinal Microbiome
/
COVID-19
Type of study:
Reviews
Topics:
Vaccines
Limits:
Humans
Language:
English
Journal:
Endocr Pract
Journal subject:
Endocrinology
Year:
2020
Document Type:
Article
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