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Decreased Gut Microbiome Tryptophan Metabolism and Serotonergic Signaling in Patients With Persistent Mental Health and Gastrointestinal Symptoms After COVID-19.
Blackett, John W; Sun, Yiwei; Purpura, Lawrence; Margolis, Kara Gross; Elkind, Mitchell S V; O'Byrne, Sheila; Wainberg, Milton; Abrams, Julian A; Wang, Harris H; Chang, Lin; Freedberg, Daniel E.
  • Blackett JW; Division of Digestive and Liver Diseases, Mayo Clinic, Rochester, Minnesota, USA.
  • Sun Y; Program in Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA.
  • Purpura L; Department of Systems Biology, Columbia University Irving Medical Center, New York, New York, USA.
  • Margolis KG; Division of Infectious Diseases, Columbia University Irving Medical Center, New York, New York, USA.
  • Elkind MSV; Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA.
  • O'Byrne S; Columbia University Digestive and Liver Diseases Research Center New York, New York, USA.
  • Wainberg M; Department of Neurology, Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA.
  • Abrams JA; Columbia University Digestive and Liver Diseases Research Center New York, New York, USA.
  • Wang HH; Department of Psychiatry, Columbia University Irving Medical Center and the New York State Psychiatric Institute; New York, New York, USA.
  • Chang L; Columbia University Digestive and Liver Diseases Research Center New York, New York, USA.
  • Freedberg DE; Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, New York, New York, USA.
Clin Transl Gastroenterol ; 13(10): e00524, 2022 10 01.
Article in English | MEDLINE | ID: covidwho-2025671
ABSTRACT

INTRODUCTION:

An estimated 15%-29% of patients report new gastrointestinal (GI) symptoms after coronavirus-19 disease (COVID-19) while 4%-31% report new depressive symptoms. These symptoms may be secondary to gut microbiome tryptophan metabolism and 5-hydroxytryptamine (5-HT)-based signaling.

METHODS:

This study used specimens from 2 patient cohorts (i) fecal samples from patients with acute COVID-19 who participated in a randomized controlled trial testing prebiotic fiber and (ii) blood samples from patients with acute COVID-19. Six months after recovering from COVID-19, both cohorts answered questions related to GI symptoms and anxiety or depression. Microbiome composition and function, focusing on tryptophan metabolism-associated pathways, and plasma 5-HT were assessed.

RESULTS:

In the first cohort (n = 13), gut microbiome L-tryptophan biosynthesis during acute COVID-19 was decreased among those who developed more severe GI symptoms (2.0-fold lower log activity comparing those with the most severe GI symptoms vs those with no symptoms, P = 0.06). All tryptophan pathways showed decreased activity among those with more GI symptoms. The same pathways were also decreased in those with the most severe mental health symptoms after COVID-19. In an untargeted analysis, 5 additional metabolic pathways significantly differed based on subsequent development of GI symptoms. In the second cohort (n = 39), plasma 5-HT concentration at the time of COVID-19 was increased 5.1-fold in those with GI symptoms alone compared with those with mental health symptoms alone ( P = 0.02).

DISCUSSION:

Acute gut microbiome-mediated reduction in 5-HT signaling may contribute to long-term GI and mental health symptoms after COVID-19. Future studies should explore modification of 5-HT signaling to reduce post-COVID symptoms.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Gastrointestinal Microbiome / Gastrointestinal Diseases / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: Clin Transl Gastroenterol Year: 2022 Document Type: Article Affiliation country: Ctg.0000000000000524

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Gastrointestinal Microbiome / Gastrointestinal Diseases / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: Clin Transl Gastroenterol Year: 2022 Document Type: Article Affiliation country: Ctg.0000000000000524