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Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19

OBJECTIVE: Although COVID-19 is primarily a respiratory illness, there is mounting evidence suggesting that the GI tract is involved in this disease. We investigated whether the gut microbiome is linked to disease severity in patients with COVID-19, and whether perturbations in microbiome compositio...

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Autores principales: Yeoh, Yun Kit, Zuo, Tao, Lui, Grace Chung-Yan, Zhang, Fen, Liu, Qin, Li, Amy YL, Chung, Arthur CK, Cheung, Chun Pan, Tso, Eugene YK, Fung, Kitty SC, Chan, Veronica, Ling, Lowell, Joynt, Gavin, Hui, David Shu-Cheong, Chow, Kai Ming, Ng, Susanna So Shan, Li, Timothy Chun-Man, Ng, Rita WY, Yip, Terry CF, Wong, Grace Lai-Hung, Chan, Francis KL, Wong, Chun Kwok, Chan, Paul KS, Ng, Siew C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7804842/
https://www.ncbi.nlm.nih.gov/pubmed/33431578
http://dx.doi.org/10.1136/gutjnl-2020-323020
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author Yeoh, Yun Kit
Zuo, Tao
Lui, Grace Chung-Yan
Zhang, Fen
Liu, Qin
Li, Amy YL
Chung, Arthur CK
Cheung, Chun Pan
Tso, Eugene YK
Fung, Kitty SC
Chan, Veronica
Ling, Lowell
Joynt, Gavin
Hui, David Shu-Cheong
Chow, Kai Ming
Ng, Susanna So Shan
Li, Timothy Chun-Man
Ng, Rita WY
Yip, Terry CF
Wong, Grace Lai-Hung
Chan, Francis KL
Wong, Chun Kwok
Chan, Paul KS
Ng, Siew C
author_facet Yeoh, Yun Kit
Zuo, Tao
Lui, Grace Chung-Yan
Zhang, Fen
Liu, Qin
Li, Amy YL
Chung, Arthur CK
Cheung, Chun Pan
Tso, Eugene YK
Fung, Kitty SC
Chan, Veronica
Ling, Lowell
Joynt, Gavin
Hui, David Shu-Cheong
Chow, Kai Ming
Ng, Susanna So Shan
Li, Timothy Chun-Man
Ng, Rita WY
Yip, Terry CF
Wong, Grace Lai-Hung
Chan, Francis KL
Wong, Chun Kwok
Chan, Paul KS
Ng, Siew C
author_sort Yeoh, Yun Kit
collection PubMed
description OBJECTIVE: Although COVID-19 is primarily a respiratory illness, there is mounting evidence suggesting that the GI tract is involved in this disease. We investigated whether the gut microbiome is linked to disease severity in patients with COVID-19, and whether perturbations in microbiome composition, if any, resolve with clearance of the SARS-CoV-2 virus. METHODS: In this two-hospital cohort study, we obtained blood, stool and patient records from 100 patients with laboratory-confirmed SARS-CoV-2 infection. Serial stool samples were collected from 27 of the 100 patients up to 30 days after clearance of SARS-CoV-2. Gut microbiome compositions were characterised by shotgun sequencing total DNA extracted from stools. Concentrations of inflammatory cytokines and blood markers were measured from plasma. RESULTS: Gut microbiome composition was significantly altered in patients with COVID-19 compared with non-COVID-19 individuals irrespective of whether patients had received medication (p<0.01). Several gut commensals with known immunomodulatory potential such as Faecalibacterium prausnitzii, Eubacterium rectale and bifidobacteria were underrepresented in patients and remained low in samples collected up to 30 days after disease resolution. Moreover, this perturbed composition exhibited stratification with disease severity concordant with elevated concentrations of inflammatory cytokines and blood markers such as C reactive protein, lactate dehydrogenase, aspartate aminotransferase and gamma-glutamyl transferase. CONCLUSION: Associations between gut microbiota composition, levels of cytokines and inflammatory markers in patients with COVID-19 suggest that the gut microbiome is involved in the magnitude of COVID-19 severity possibly via modulating host immune responses. Furthermore, the gut microbiota dysbiosis after disease resolution could contribute to persistent symptoms, highlighting a need to understand how gut microorganisms are involved in inflammation and COVID-19.
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spelling pubmed-78048422021-01-14 Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19 Yeoh, Yun Kit Zuo, Tao Lui, Grace Chung-Yan Zhang, Fen Liu, Qin Li, Amy YL Chung, Arthur CK Cheung, Chun Pan Tso, Eugene YK Fung, Kitty SC Chan, Veronica Ling, Lowell Joynt, Gavin Hui, David Shu-Cheong Chow, Kai Ming Ng, Susanna So Shan Li, Timothy Chun-Man Ng, Rita WY Yip, Terry CF Wong, Grace Lai-Hung Chan, Francis KL Wong, Chun Kwok Chan, Paul KS Ng, Siew C Gut Gut Microbiota OBJECTIVE: Although COVID-19 is primarily a respiratory illness, there is mounting evidence suggesting that the GI tract is involved in this disease. We investigated whether the gut microbiome is linked to disease severity in patients with COVID-19, and whether perturbations in microbiome composition, if any, resolve with clearance of the SARS-CoV-2 virus. METHODS: In this two-hospital cohort study, we obtained blood, stool and patient records from 100 patients with laboratory-confirmed SARS-CoV-2 infection. Serial stool samples were collected from 27 of the 100 patients up to 30 days after clearance of SARS-CoV-2. Gut microbiome compositions were characterised by shotgun sequencing total DNA extracted from stools. Concentrations of inflammatory cytokines and blood markers were measured from plasma. RESULTS: Gut microbiome composition was significantly altered in patients with COVID-19 compared with non-COVID-19 individuals irrespective of whether patients had received medication (p<0.01). Several gut commensals with known immunomodulatory potential such as Faecalibacterium prausnitzii, Eubacterium rectale and bifidobacteria were underrepresented in patients and remained low in samples collected up to 30 days after disease resolution. Moreover, this perturbed composition exhibited stratification with disease severity concordant with elevated concentrations of inflammatory cytokines and blood markers such as C reactive protein, lactate dehydrogenase, aspartate aminotransferase and gamma-glutamyl transferase. CONCLUSION: Associations between gut microbiota composition, levels of cytokines and inflammatory markers in patients with COVID-19 suggest that the gut microbiome is involved in the magnitude of COVID-19 severity possibly via modulating host immune responses. Furthermore, the gut microbiota dysbiosis after disease resolution could contribute to persistent symptoms, highlighting a need to understand how gut microorganisms are involved in inflammation and COVID-19. BMJ Publishing Group 2021-04 2021-01-11 /pmc/articles/PMC7804842/ /pubmed/33431578 http://dx.doi.org/10.1136/gutjnl-2020-323020 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Gut Microbiota
Yeoh, Yun Kit
Zuo, Tao
Lui, Grace Chung-Yan
Zhang, Fen
Liu, Qin
Li, Amy YL
Chung, Arthur CK
Cheung, Chun Pan
Tso, Eugene YK
Fung, Kitty SC
Chan, Veronica
Ling, Lowell
Joynt, Gavin
Hui, David Shu-Cheong
Chow, Kai Ming
Ng, Susanna So Shan
Li, Timothy Chun-Man
Ng, Rita WY
Yip, Terry CF
Wong, Grace Lai-Hung
Chan, Francis KL
Wong, Chun Kwok
Chan, Paul KS
Ng, Siew C
Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19
title Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19
title_full Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19
title_fullStr Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19
title_full_unstemmed Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19
title_short Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19
title_sort gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with covid-19
topic Gut Microbiota
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7804842/
https://www.ncbi.nlm.nih.gov/pubmed/33431578
http://dx.doi.org/10.1136/gutjnl-2020-323020
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