From the Guidelines
The gut microbiome is likely involved in the transmission and severity of COVID-19, with evidence suggesting that SARS-CoV-2 can infect and replicate within enterocytes in the gastrointestinal tract, leading to potential faecal-oral transmission 1.
Key Findings
- The presence of SARS-CoV-2 RNA in stool specimens can be independent of gastrointestinal symptoms, and some patients with COVID-19 may have negative pharyngeal swabs but positive stool real-time RT-PCR for SARS-CoV-2 1.
- The intestinal epithelium supports virus replication, and the viral concentration of SARS-CoV-2 in stool may be sufficient for transmission, although this remains unclear 1.
- Both airborne transmission and faecal-oral transmission should be considered in understanding and reducing the risk of infection during endoscopic procedures 1.
Clinical Implications
- Patients undergoing endoscopy should be screened for COVID-19 symptoms and contact history before the procedure, and those with suspected or confirmed COVID-19 should be postponed or rescheduled according to clinical condition 1.
- Healthcare professionals should use disposable protective measures to prevent infection transmission during endoscopy, and patients should be advised to perform specific tests or contact emergency services if they develop symptoms 1.
- Maintaining a healthy gut microbiome through a balanced diet and potentially probiotics or prebiotics may help support immune function during COVID-19 infection, although more research is needed to develop targeted microbiome-based interventions 1.
From the Research
Relationship between Gut Microbiome and COVID-19
The relationship between the gut microbiome and Coronavirus disease (COVID-19) is complex and has been the subject of several studies.
- The gut microbiome plays a crucial role in the immune system, and alterations in the gut microbiome, also known as dysbiosis, have been linked to various diseases, including COVID-19 2, 3, 4.
- Studies have shown that patients with COVID-19 have an altered gut microbiome compared to healthy individuals, and this alteration is associated with disease severity 2, 3, 4.
- Probiotics, prebiotics, and dietary approaches have been suggested as potential therapeutic strategies to modulate the gut microbiome and prevent or reduce the severity of COVID-19 2, 3, 5, 4.
Role of Probiotics in COVID-19
Probiotics have been shown to have immunomodulatory effects and may play a role in preventing or reducing the severity of COVID-19.
- Some studies have reported that probiotics, such as Lactobacillus and Bifidobacterium, may have antiviral properties and can modulate the immune response to reduce inflammation and improve outcomes in COVID-19 patients 2, 3, 5.
- However, other studies have found that the current evidence does not suggest that probiotics affect COVID-19 severity or mortality, and more high-quality studies are needed to determine their effectiveness 6.
Mechanisms of Gut Microbiome Modulation
The mechanisms by which the gut microbiome is modulated in COVID-19 are not fully understood, but several studies have suggested that:
- The gut microbiome can influence the immune response and inflammation in the body, and alterations in the gut microbiome can lead to immune dysfunction and increased susceptibility to COVID-19 2, 3, 4.
- Probiotics and prebiotics can modulate the gut microbiome and have anti-inflammatory effects, which may help to reduce the severity of COVID-19 2, 3, 5, 4.
- Dietary approaches, such as a diversified diet, may also help to strengthen the intestinal barrier and reduce pro-inflammatory states, which can help to prevent or reduce the severity of COVID-19 4.