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Gut microbiota composition during hospitalization is associated with 60-day mortality after severe COVID-19.
Trøseid, Marius; Holter, Jan Cato; Holm, Kristian; Vestad, Beate; Sazonova, Taisiia; Granerud, Beathe K; Dyrhol-Riise, Anne Ma; Holten, Aleksander R; Tonby, Kristian; Kildal, Anders Benjamin; Heggelund, Lars; Tveita, Anders; Bøe, Simen; Müller, Karl Erik; Jenum, Synne; Hov, Johannes R; Ueland, Thor.
  • Trøseid M; Research Institute of Internal Medicine, Oslo University Hospital, 0424, Oslo, Norway. marius.troseid@medisin.uio.no.
  • Holter JC; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, 0424, Oslo, Norway. marius.troseid@medisin.uio.no.
  • Holm K; Institute of Clinical Medicine, University of Oslo, 0315, Oslo, Norway. marius.troseid@medisin.uio.no.
  • Vestad B; Institute of Clinical Medicine, University of Oslo, 0315, Oslo, Norway.
  • Sazonova T; Department of Microbiology, Oslo University Hospital, 0424, Oslo, Norway.
  • Granerud BK; Research Institute of Internal Medicine, Oslo University Hospital, 0424, Oslo, Norway.
  • Dyrhol-Riise AM; Institute of Clinical Medicine, University of Oslo, 0315, Oslo, Norway.
  • Holten AR; Department of Transplantation Medicine, Norwegian PSC Research Center, Oslo University Hospital, Oslo, Norway.
  • Tonby K; Research Institute of Internal Medicine, Oslo University Hospital, 0424, Oslo, Norway.
  • Kildal AB; Department of Transplantation Medicine, Norwegian PSC Research Center, Oslo University Hospital, Oslo, Norway.
  • Heggelund L; Research Institute of Internal Medicine, Oslo University Hospital, 0424, Oslo, Norway.
  • Tveita A; Department of Transplantation Medicine, Norwegian PSC Research Center, Oslo University Hospital, Oslo, Norway.
  • Bøe S; Institute of Clinical Medicine, University of Oslo, 0315, Oslo, Norway.
  • Müller KE; Department of Microbiology, Oslo University Hospital, 0424, Oslo, Norway.
  • Jenum S; Institute of Clinical Medicine, University of Oslo, 0315, Oslo, Norway.
  • Hov JR; Department of Infectious Diseases, Oslo University Hospital, 0424, Oslo, Norway.
  • Ueland T; Institute of Clinical Medicine, University of Oslo, 0315, Oslo, Norway.
Crit Care ; 27(1): 69, 2023 02 23.
Article in English | MEDLINE | ID: covidwho-2284552
ABSTRACT

BACKGROUND:

Gut microbiota alterations have been reported in hospitalized COVID-19 patients, with reduced alpha diversity and altered microbiota composition related to respiratory failure. However, data regarding gut microbiota and mortality are scarce.

METHODS:

Rectal swabs for gut microbiota analyses were collected within 48 h after hospital admission (baseline; n = 123) and three-month post-admission (n = 50) in a subset of patients included in the Norwegian SARS-CoV2 cohort study. Samples were analysed by sequencing the 16S rRNA gene. Gut microbiota diversity and composition at baseline were assessed in relation to need for intensive care unit (ICU) admission during hospitalization. The primary objective was to investigate whether the ICU-related gut microbiota was associated with 60-day mortality.

RESULTS:

Gut microbiota diversity (Shannon index) at baseline was lower in COVID-19 patients requiring ICU admission during hospitalization than in those managed in general wards. A dysbiosis index representing a balance of enriched and reduced taxa in ICU compared with ward patients, including decreased abundance of butyrate-producing microbes and enrichment of a partly oral bacterial flora, was associated with need of ICU admission independent of antibiotic use, dexamethasone use, chronic pulmonary disease, PO2/FiO2 ratio, C-reactive protein, neutrophil counts or creatinine levels (adjusted p < 0.001). The ICU-related dysbiosis index at baseline correlated with systemic inflammation and was associated with 60-day mortality in univariate analyses (Hazard ratio 3.70 [2.00-8.6], p < 0.001), as well as after separate adjustment for covariates. At the three-month follow-up, the dysbiosis index remained elevated in ICU patients compared with ward patients (adjusted p = 0.007).

CONCLUSIONS:

Although our data should be regarded as exploratory due to low number of clinical end points, they suggest that gut microbiota alterations during hospitalization could be related to poor prognosis after severe COVID-19. Larger studies of gut involvement during COVID-19 in relation to long-term clinical outcome are warranted. Trial registration NCT04381819 . Retrospectively registered May 11, 2020.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Gastrointestinal Microbiome / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Crit Care Year: 2023 Document Type: Article Affiliation country: S13054-023-04356-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Gastrointestinal Microbiome / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Crit Care Year: 2023 Document Type: Article Affiliation country: S13054-023-04356-2