Clinical implications of gut microbiota and cytokine responses in coronavirus disease prognosis.

Objectives: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects gut luminal cells through the angiotensin-converting enzyme-2 receptor and disrupts the gut microbiome. We investigated whether the gut microbiome in the early stage of SARS-CoV-2 infection was associated with the prognosis of coronavirus disease (COVID-19).
Methods: Thirty COVID-19 patients and 16 healthy controls were prospectively enrolled. Blood and stool samples and clinical details were collected on days 0 (enrollment), 7, 14, and 28. Participants were categorized into four groups by their clinical course.
Results: Gut microbiota composition varied during the clinical course of COVID-19 and was closely associated with cytokine levels ( p =0.003). A high abundance of the genus Dialister (linear discriminant analysis [LDA] effect size: 3.97856, p =0.004), species Peptoniphilus lacrimalis (LDA effect size: 4.00551, p =0.020), and Anaerococcus prevotii (LDA effect size: 4.00885, p =0.007) was associated with a good prognosis. Starch, sucrose, and galactose metabolism was highly activated in the gut microbiota of the poor prognosis group. Glucose-lowering diets, including whole grains, were positively correlated with a good prognosis.
Conclusion: Gut microbiota may mediate the prognosis of COVID-19 by regulating cytokine responses and controlling glucose metabolism, which is implicated in the host immune response to SARS-CoV-2.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Seong, Kim, Han, Seo, Hyun, Yoon, Nham, Noh, Cheong, Kim, Lim and Song.)