Does chronic inflammation cause acute inflammation to spiral into hyper-inflammation in a manner modulated by diet and the gut microbiome, in severe Covid-19?

Bioessays. 2021 Sep;43(9):e2000211. doi: 10.1002/bies.202000211. Epub 2021 Jul 2.


We propose that hyper-inflammation (HYPi) is a ''runaway'' consequence of acute inflammation (ACUi) that arises more easily (and also abates less easily) in those who host a pre-existing chronic inflammation (CHRi), because (i) most factors involved in generating an ACUi to limit viral proliferation are already present when there is an underlying CHRi, and also because (ii) anti-inflammatory (AI) mechanisms for the abatement of ACUi (following containment of viral proliferation) are suppressed and desensitized where there is an underlying CHRi, with this causing the ACUi to spiral into a HYPi. Stress, pollution, diet, and gut microbiomes (alterable in weeks through dietary changes) have an intimate and bidirectional cause-effect relationship with CHRi. We propose that avoidance of CHRi-promoting foods and adoption of CHRi-suppressing foods could reduce susceptibility to HYPi, in Covid-19 and in other viral diseases, such as influenza, which are characterized by episodic and unpredictable HYPi.

Keywords: Acute inflammation; Chronic inflammation; Covid-19; Cytokine storm; Diet; Gut inflammation; Gut microbiome; Hyperinflammation; Systemic inflammation.

MeSH terms

  • COVID-19* / diagnosis
  • COVID-19* / physiopathology
  • Diet* / adverse effects
  • Gastrointestinal Microbiome*
  • Humans
  • Inflammation / physiopathology*