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Bacterial and Fungal Gut Dysbiosis and Clostridium difficile in COVID-19: A Review.
Linares-García, Laura; Cárdenas-Barragán, María E; Hernández-Ceballos, Winston; Pérez-Solano, Carlos S; Morales-Guzmán, Alizon S; Miller, Danielle S; Schmulson, Max.
  • Linares-García L; Laboratorio de Hígado, Páncreas y Motilidad (HIPAM), Unidad de Investigación en Medicina Experimental, Facultad de Medicina-Universidad Nacional Autónoma de México (UNAM).
  • Cárdenas-Barragán ME; Laboratorio de Hígado, Páncreas y Motilidad (HIPAM), Unidad de Investigación en Medicina Experimental, Facultad de Medicina-Universidad Nacional Autónoma de México (UNAM).
  • Hernández-Ceballos W; Laboratorio de Hígado, Páncreas y Motilidad (HIPAM), Unidad de Investigación en Medicina Experimental, Facultad de Medicina-Universidad Nacional Autónoma de México (UNAM).
  • Pérez-Solano CS; Program of Combined Studies in Medicine. Faculty of Medicine-Universidad Nacional Autónoma de México (UNAM), Mexico City, México.
  • Morales-Guzmán AS; Laboratorio de Hígado, Páncreas y Motilidad (HIPAM), Unidad de Investigación en Medicina Experimental, Facultad de Medicina-Universidad Nacional Autónoma de México (UNAM).
  • Miller DS; Program of Combined Studies in Medicine. Faculty of Medicine-Universidad Nacional Autónoma de México (UNAM), Mexico City, México.
  • Schmulson M; Laboratorio de Hígado, Páncreas y Motilidad (HIPAM), Unidad de Investigación en Medicina Experimental, Facultad de Medicina-Universidad Nacional Autónoma de México (UNAM).
J Clin Gastroenterol ; 56(4): 285-298, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1865009
ABSTRACT

BACKGROUND:

Gastrointestinal symptoms are common in Coronavirus Disease 2019 (COVID-19), related to infection of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) of intestinal cells through the angiotensin converting enzyme 2 (ACE2) receptor in the brush border. Also, patients are treated with multiple antibiotics. Therefore, an increase in gut dysbiosis and in the prevalence of Clostridium difficile infection (CDI) is expected in patients with COVID-19.

METHODS:

A PubMed search was conducted using the terms "gut microbiota," "gut mycobiota," "dysbiosis" AND "COVID-19"; "Clostridium difficile," "Clostridioides difficile" AND "COVID-19"; "probiotics," "bacteriotherapy AND COVID-19." Only case series, observational and experimental studies were included.

RESULTS:

A total of 384 papers were retrieved and 21 fulfilled selection criteria. Later, a new paper was identified, thus 22 papers were reviewed. Main

findings:

(1) gut bacterial dysbiosis has been found in fecal samples of COVID-19 patients, with enrichment of opportunistic organisms and decrease of beneficial commensals such as Faecalibacterium prausnitizii. Dysbiosis is related to inflammatory markers and illness severity. (2) There is evidence for abnormal gut barrier and bacterial translocation with a negative impact in the lungs. (3) Fungal dysbiosis correlating with pulmonary mycobiota, has also been found. (4) There is controversy in the CDI rates among COVID-19 patients versus controls and pandemic versus prepandemic era. (5) There is no available evidence yet to support bacteriotherapy in COVID-19. (6) Fecal microbiota transplantation (FMT) has been proposed for COVID-19, although there is no evidence to support it. Also, FMT can be safely used during the pandemic for CDI if strict screening protocols for donors and fecal product are implemented.

CONCLUSIONS:

In COVID-19 there is bacterial and fungal dysbiosis that correlates with systemic and pulmonary inflammation, and illness severity. Further investigations are warranted to determine the efficacy of bacteriotherapy and FMT for modulating gut dysbiosis in COVID-19.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Clostridioides difficile / Clostridium Infections / COVID-19 Type of study: Observational study / Prognostic study / Reviews Limits: Humans Language: English Journal: J Clin Gastroenterol Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Clostridioides difficile / Clostridium Infections / COVID-19 Type of study: Observational study / Prognostic study / Reviews Limits: Humans Language: English Journal: J Clin Gastroenterol Year: 2022 Document Type: Article