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Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary Therapeutic Strategy to Avoid the Progression of COVID-19.
d'Ettorre, Gabriella; Ceccarelli, Giancarlo; Marazzato, Massimiliano; Campagna, Giuseppe; Pinacchio, Claudia; Alessandri, Francesco; Ruberto, Franco; Rossi, Giacomo; Celani, Luigi; Scagnolari, Carolina; Mastropietro, Cristina; Trinchieri, Vito; Recchia, Gregorio Egidio; Mauro, Vera; Antonelli, Guido; Pugliese, Francesco; Mastroianni, Claudio Maria.
  • d'Ettorre G; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Ceccarelli G; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Marazzato M; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Campagna G; Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.
  • Pinacchio C; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Alessandri F; Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Rome, Italy.
  • Ruberto F; Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Rome, Italy.
  • Rossi G; School of Biosciences, Veterinary Medicine University of Camerino, Camerino, Italy.
  • Celani L; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Scagnolari C; Laboratory of Virology, Department of Molecular Medicine, Affiliated to Istituto Pasteur Italia - Cenci Bolognetti Foundation, Sapienza University, Rome, Italy.
  • Mastropietro C; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Trinchieri V; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Recchia GE; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Mauro V; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Antonelli G; Laboratory of Virology, Department of Molecular Medicine, Affiliated to Istituto Pasteur Italia - Cenci Bolognetti Foundation, Sapienza University, Rome, Italy.
  • Pugliese F; Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Rome, Italy.
  • Mastroianni CM; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Front Med (Lausanne) ; 7: 389, 2020.
Article in English | MEDLINE | ID: covidwho-685804
Semantic information from SemMedBD (by NLM)
1. Epithelial Cells PART_OF Intestines
Subject
Epithelial Cells
Predicate
PART_OF
Object
Intestines
2. Gastrointestinal Diseases COEXISTS_WITH COVID-19
Subject
Gastrointestinal Diseases
Predicate
COEXISTS_WITH
Object
COVID-19
3. IMPACT gene INTERACTS_WITH Epithelial Cells
Subject
IMPACT gene
Predicate
INTERACTS_WITH
Object
Epithelial Cells
4. Therapeutic procedure TREATS COVID-19
Subject
Therapeutic procedure
Predicate
TREATS
Object
COVID-19
5. Fever PROCESS_OF Patients
Subject
Fever
Predicate
PROCESS_OF
Object
Patients
6. Antibiotics ADMINISTERED_TO Patients
Subject
Antibiotics
Predicate
ADMINISTERED_TO
Object
Patients
7. hydroxychloroquine ADMINISTERED_TO Patients
Subject
hydroxychloroquine
Predicate
ADMINISTERED_TO
Object
Patients
8. tocilizumab ADMINISTERED_TO Patients
Subject
tocilizumab
Predicate
ADMINISTERED_TO
Object
Patients
9. Respiratory Failure PROCESS_OF Patients
Subject
Respiratory Failure
Predicate
PROCESS_OF
Object
Patients
10. Epithelial Cells PART_OF Intestines
Subject
Epithelial Cells
Predicate
PART_OF
Object
Intestines
11. Gastrointestinal Diseases COEXISTS_WITH COVID-19
Subject
Gastrointestinal Diseases
Predicate
COEXISTS_WITH
Object
COVID-19
12. IMPACT gene INTERACTS_WITH Epithelial Cells
Subject
IMPACT gene
Predicate
INTERACTS_WITH
Object
Epithelial Cells
13. Therapeutic procedure TREATS COVID-19
Subject
Therapeutic procedure
Predicate
TREATS
Object
COVID-19
14. Fever PROCESS_OF Patients
Subject
Fever
Predicate
PROCESS_OF
Object
Patients
15. Antibiotics ADMINISTERED_TO Patients
Subject
Antibiotics
Predicate
ADMINISTERED_TO
Object
Patients
16. hydroxychloroquine ADMINISTERED_TO Patients
Subject
hydroxychloroquine
Predicate
ADMINISTERED_TO
Object
Patients
17. tocilizumab ADMINISTERED_TO Patients
Subject
tocilizumab
Predicate
ADMINISTERED_TO
Object
Patients
18. Respiratory Failure PROCESS_OF Patients
Subject
Respiratory Failure
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

Background:

Gastrointestinal disorders are frequent in COVID-19 and SARS-CoV-2 has been hypothesized to impact on host microbial flora and gut inflammation, infecting intestinal epithelial cells. Since there are currently no coded therapies or guidelines for treatment of COVID-19, this study aimed to evaluate the possible role of a specific oral bacteriotherapy as complementary therapeutic strategy to avoid the progression of COVID-19.

Methods:

We provide a report of 70 patients positive for COVID-19, hospitalized between March 9th and April 4th, 2020. All the patients had fever, required non-invasive oxygen therapy and presented a CT lung involvement on imaging more than 50%. Forty-two patients received hydroxychloroquine, antibiotics, and tocilizumab, alone or in combination. A second group of 28 subjects received the same therapy added with oral bacteriotherapy, using a multistrain formulation.

Results:

The two cohorts of patients were comparable for age, sex, laboratory values, concomitant pathologies, and the modality of oxygen support. Within 72 h, nearly all patients treated with bacteriotherapy showed remission of diarrhea and other symptoms as compared to less than half of the not supplemented group. The estimated risk of developing respiratory failure was eight-fold lower in patients receiving oral bacteriotherapy. Both the prevalence of patients transferred to ICU and mortality were higher among the patients not treated with oral bacteriotherapy.

Conclusions:

A specific bacterial formulation showed a significant ameliorating impact on the clinical conditions of patients positive for SARS-CoV-2 infection. These results also stress the importance of the gut-lung axis in controlling the COVID-19 disease.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Language: English Journal: Front Med (Lausanne) Clinical aspect: Etiology Year: 2020

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Language: English Journal: Front Med (Lausanne) Clinical aspect: Etiology Year: 2020
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