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BMC Infect Dis . Temporal changes in fecal microbiota of patients infected with COVID-19: a longitudinal cohort

tetano

Editor, Senior Moderator
BMC Infect Dis


. 2023 Aug 18;23(1):537.
doi: 10.1186/s12879-023-08511-6. Temporal changes in fecal microbiota of patients infected with COVID-19: a longitudinal cohort

Tatiana Galperine[SUP] #[/SUP][SUP] 1 [/SUP], Yangji Choi[SUP] #[/SUP][SUP] 2 [/SUP], Jean-Luc Pagani[SUP] 3 [/SUP], Antonios Kritikos[SUP] 1 2 [/SUP], Matthaios Papadimitriou-Olivgeris[SUP] 1 [/SUP], Marie Méan[SUP] 4 [/SUP], Valentin Scherz[SUP] 2 [/SUP], Onya Opota[SUP] 2 [/SUP], Gilbert Greub[SUP] 2 [/SUP], Benoit Guery[SUP] #[/SUP][SUP] 5 [/SUP], Claire Bertelli[SUP] #[/SUP][SUP] 2 [/SUP]; RegCOVID Study Group



Collaborators, Affiliations
Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a multifaceted disease potentially responsible for various clinical manifestations including gastro-intestinal symptoms. Several evidences suggest that the intestine is a critical site of immune cell development, gut microbiota could therefore play a key role in lung immune response. We designed a monocentric longitudinal observational study to describe the gut microbiota profile in COVID-19 patients and compare it to a pre-existing cohort of ventilated non-COVID-19 patients.
Methods: From March to December 2020, we included patients admitted for COVID-19 in medicine (43 not ventilated) or intensive care unit (ICU) (14 ventilated) with a positive SARS-CoV-2 RT-PCR assay in a respiratory tract sample. 16S metagenomics was performed on rectal swabs from these 57 COVID-19 patients, 35 with one and 22 with multiple stool collections. Nineteen non-COVID-19 ICU controls were also enrolled, among which 14 developed ventilator-associated pneumonia (pneumonia group) and five remained without infection (control group). SARS-CoV-2 viral loads in fecal samples were measured by qPCR.
Results: Although similar at inclusion, Shannon alpha diversity appeared significantly lower in COVID-19 and pneumonia groups than in the control group at day 7. Furthermore, the microbiota composition became distinct between COVID-19 and non-COVID-19 groups. The fecal microbiota of COVID-19 patients was characterized by increased Bacteroides and the pneumonia group by Prevotella. In a distance-based redundancy analysis, only COVID-19 presented significant effects on the microbiota composition. Moreover, patients in ICU harbored increased Campylobacter and decreased butyrate-producing bacteria, such as Lachnospiraceae, Roseburia and Faecalibacterium as compared to patients in medicine. Both the stay in ICU and patient were significant factors affecting the microbiota composition. SARS-CoV-2 viral loads were higher in ICU than in non-ICU patients.
Conclusions: Overall, we identified distinct characteristics of the gut microbiota in COVID-19 patients compared to control groups. COVID-19 patients were primarily characterized by increased Bacteroides and decreased Prevotella. Moreover, disease severity showed a negative correlation with butyrate-producing bacteria. These features could offer valuable insights into potential targets for modulating the host response through the microbiota and contribute to a better understanding of the disease's pathophysiology.
Trial registration: CER-VD 2020-00755 (05.05.2020) & 2017-01820 (08.06.2018).

Keywords: COVID-19; Gut microbiota; Gut-lung axis; Microbiota profiling; SARS-CoV-2.

 
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