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Front Immunol . Persistent Systemic Microbial Translocation and Intestinal Damage During Coronavirus Disease-19

tetano

Editor, Senior Moderator
Front Immunol


. 2021 Jul 14;12:708149.
doi: 10.3389/fimmu.2021.708149. eCollection 2021.
Persistent Systemic Microbial Translocation and Intestinal Damage During Coronavirus Disease-19


Alessandra Oliva[SUP] 1 [/SUP], Maria Claudia Miele[SUP] 1 [/SUP], Federica Di Timoteo[SUP] 1 [/SUP], Massimiliano De Angelis[SUP] 1 [/SUP], Vera Mauro[SUP] 1 [/SUP], Raissa Aronica[SUP] 1 [/SUP], Dania Al Ismail[SUP] 1 [/SUP], Giancarlo Ceccarelli[SUP] 1 [/SUP], Claudia Pinacchio[SUP] 1 [/SUP], Gabriella d'Ettorre[SUP] 1 [/SUP], Maria Teresa Mascellino[SUP] 1 [/SUP], Claudio M Mastroianni[SUP] 1 [/SUP]



Affiliations

Abstract

Microbial translocation (MT) and intestinal damage (ID) are poorly explored in COVID-19. Aims were to assess whether alteration of gut permeability and cell integrity characterize COVID-19 patients, whether it is more pronounced in severe infections and whether it influences the development of subsequent bloodstream infection (BSI). Furthermore, we looked at the potential predictive role of TM and ID markers on Intensive Care Unit (ICU) admission and in-hospital mortality. Over March-July 2020, 45 COVID-19 patients were enrolled. Markers of MT [LPB (Lipopolysacharide Binding Protein) and EndoCab IgM] and ID [I-FABP (Intestinal Fatty Acid Binding Protein)] were evaluated at COVID-19 diagnosis and after 7 days. As a control group, age- and gender-matched healthy donors (HDs) enrolled during the same study period were included. Median age was 66 (56-71) years. Twenty-one (46.6%) were admitted to ICU and mortality was 22% (10/45). Compared to HD, a high degree of MT and ID was observed. ICU patients had higher levels of MT, but not of ID, than non-ICU ones. Likewise, patients with BSI had lower EndoCab IgM than non-BSI. Interestingly, patients with high degree of MT and low ID were likely to be admitted to ICU (AUC 0.822). Patients with COVID-19 exhibited high level of MT, especially subjects admitted to ICU. COVID-19 is associated with gut permeability.

Keywords: COVID-19; SARS-CoV-2; intestinal damage; intestinal damage and permeability; intestinal fatty acid binding protein (I-FABP); lipopolysacharide binding protein; microbial translocation; microbial translocation in COVID-19.
 
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