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. 2022 Jan-Dec;14(1):2031840.
doi: 10.1080/19490976.2022.2031840.

Gut bacterial dysbiosis and instability is associated with the onset of complications and mortality in COVID-19

David Schult  1 , Sandra Reitmeier  2   3 , Plamena Koyumdzhieva  1 , Tobias Lahmer  1 , Moritz Middelhoff  1 , Johanna Erber  1 , Jochen Schneider  1 , Juliane Kager  1 , Marina Frolova  1 , Julia Horstmann  1 , Lisa Fricke  1 , Katja Steiger  4 , Moritz Jesinghaus  4   5 , Klaus-Peter Janssen  6 , Ulrike Protzer  7 , Klaus Neuhaus  2 , Roland M Schmid  1 , Dirk Haller  2   3 , Michael Quante  1   8
Affiliations

Gut bacterial dysbiosis and instability is associated with the onset of complications and mortality in COVID-19

David Schult et al. Gut Microbes. 2022 Jan-Dec.

Abstract

There is a growing debate about the involvement of the gut microbiome in COVID-19, although it is not conclusively understood whether the microbiome has an impact on COVID-19, or vice versa, especially as analysis of amplicon data in hospitalized patients requires sophisticated cohort recruitment and integration of clinical parameters. Here, we analyzed fecal and saliva samples from SARS-CoV-2 infected and post COVID-19 patients and controls considering multiple influencing factors during hospitalization. 16S rRNA gene sequencing was performed on fecal and saliva samples from 108 COVID-19 and 22 post COVID-19 patients, 20 pneumonia controls and 26 asymptomatic controls. Patients were recruited over the first and second corona wave in Germany and detailed clinical parameters were considered. Serial samples per individual allowed intra-individual analysis. We found the gut and oral microbiota to be altered depending on number and type of COVID-19-associated complications and disease severity. The occurrence of individual complications was correlated with low-risk (e.g., Faecalibacterium prausznitzii) and high-risk bacteria (e.g., Parabacteroides ssp.). We demonstrated that a stable gut bacterial composition was associated with a favorable disease progression. Based on gut microbial profiles, we identified a model to estimate mortality in COVID-19. Gut microbiota are associated with the occurrence of complications in COVID-19 and may thereby influencing disease severity. A stable gut microbial composition may contribute to a favorable disease progression and using bacterial signatures to estimate mortality could contribute to diagnostic approaches. Importantly, we highlight challenges in the analysis of microbial data in the context of hospitalization.

Keywords: Coronavirus; SARS-CoV-2; complications; gut microbiome; oral microbiome.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Microbial Composition of the Gut Observed in the Cohort.
Figure 2.
Figure 2.
Microbial Profile of the Gut is Associated with Disease Severity.
Figure 3.
Figure 3.
Association Between Gut Bacterial Composition and Common Complications.
Figure 4.
Figure 4.
Stability of the Bacterial Composition Related to COVID-19 and Longitudinal Analysis.
See this image and copyright information in PMC

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References

    1. Zuo T, Liu Q, Zhang F, Lui GC, Tso EY, and Yeoh YK, et al. Depicting SARS-CoV-2 faecal viral activity in association with Gut Microbiota composition in patients with COVID-19. Gut 2021. 70:276–15. doi:10.1080/19490976.2020.1747329 - DOI - PMC - PubMed
    1. Liang W, Feng Z, Rao S, Xiao C, Xue X, Lin Z, et al. Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus. Gut. 2020;69:1141–1143. - PubMed
    1. Cheung KS, Hung IFN, Chan PPY, Lung KC, Tso E, Liu R, et al. Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: systematic Review and Meta-analysis. Gastroenterology. 2020;159:81–95. - PMC - PubMed
    1. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC.. Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): a Review. Jama. 2020;324:782–793. - PubMed
    1. Mao R, Qiu Y, He JS, Tan JY, Li XH, Liang J, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020;5:667–678. - PMC - PubMed

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Grants and funding

Internal funds of Technical University of Munich to CoMRI (cohort study for patients tested positive for SARS-CoV-2), Deutsche Forschungsgemeinschaft (DFG) grant 395357507 - Sonderforschungsbereich 1371.