Probiotics for the prevention and treatment of COVID-19: a rapid systematic review and meta-analysis

Aruba Sohail; Huzaifa Ahmad Cheema; Maidah Sohail Mithani; Abia Shahid; Ahmad Nawaz; Alaa Hamza Hermis; Sampath Chinnam; Abdulqadir J Nashwan; Ivan Cherrez-Ojeda; Rehmat Ullah Awan; Sharjeel Ahmad

doi:10.3389/fnut.2023.1274122

Probiotics for the prevention and treatment of COVID-19: a rapid systematic review and meta-analysis

Front Nutr. 2023 Oct 27:10:1274122. doi: 10.3389/fnut.2023.1274122. eCollection 2023.

Authors

Affiliations

¹ Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
² Division of Infectious Diseases, Department of Medicine, King Edward Medical University, Lahore, Pakistan.
³ Nursing Department, Al-Mustaqbal University College, Hillah, Babylon, Iraq.
⁴ Department of Chemistry, M. S. Ramaiah Institute of Technology (Affiliated to Visvesvaraya Technological University, Belgaum), Bengaluru, Karnataka, India.
⁵ Hamad Medical Corporation, Doha, Qatar.
⁶ Respiralab Research Center, Guayaquil, Ecuador.
⁷ Universidad Espíritu Santo, Guayaquil, Ecuador.
⁸ Department of Medicine, Ochsner Rush Medical Center, Meridian, MS, United States.
⁹ Department of Medicine, Section of Infectious Diseases, University of Illinois College of Medicine at Peoria, Peoria, IL, United States.

^# Contributed equally.

Abstract

Background: Although numerous modalities are currently in use for the treatment and prophylaxis of COVID-19, probiotics are a cost-effective alternative that could be used in diverse clinical settings. Hence, we conducted a meta-analysis to investigate the role of probiotics in preventing and treating COVID-19 infection.

Methods: We searched several databases from inception to 30 May 2023 for all randomized controlled trials (RCTs) and comparative observational studies that evaluated probiotics (irrespective of the regimen) for the treatment or prevention of COVID-19. We conducted our meta-analysis using RevMan 5.4 with risk ratio (RR) and mean difference (MD) as the effect measures.

Results: A total of 18 studies (11 RCTs and 7 observational studies) were included in our review. Probiotics reduced the risk of mortality (RR 0.40; 95% CI: 0.25-0.65, I² = 0%). Probiotics also decreased the length of hospital stay, rate of no recovery, and time to recovery. However, probiotics had no effect on the rates of ICU admission. When used prophylactically, probiotics did not decrease the incidence of COVID-19 cases (RR 0.65; 95% CI: 0.37-1.12; I² = 66%). The results for all outcomes were consistent across the subgroups of RCTs and observational studies (P for interaction >0.05).

Conclusion: The results of this meta-analysis support the use of probiotics as an adjunct treatment for reducing the risk of mortality or improving other clinical outcomes in patients with COVID-19. However, probiotics are not useful as a prophylactic measure against COVID-19. Large-scale RCTs are still warranted for determining the most efficacious and safe probiotic strains.

Systematic review registration: PROSPERO (CRD42023390275: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=390275).

Keywords: COVID-19; SARS-CoV-2; meta-analysis; probiotics; synbiotics.

Publication types

Systematic Review

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.