RT Journal Article
SR Electronic
T1 Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 698
OP 706
DO 10.1136/gutjnl-2020-323020
VO 70
IS 4
A1 Yun Kit Yeoh
A1 Tao Zuo
A1 Grace Chung-Yan Lui
A1 Fen Zhang
A1 Qin Liu
A1 Amy YL Li
A1 Arthur CK Chung
A1 Chun Pan Cheung
A1 Eugene YK Tso
A1 Kitty SC Fung
A1 Veronica Chan
A1 Lowell Ling
A1 Gavin Joynt
A1 David Shu-Cheong Hui
A1 Kai Ming Chow
A1 Susanna So Shan Ng
A1 Timothy Chun-Man Li
A1 Rita WY Ng
A1 Terry CF Yip
A1 Grace Lai-Hung Wong
A1 Francis KL Chan
A1 Chun Kwok Wong
A1 Paul KS Chan
A1 Siew C Ng
YR 2021
UL http://gut.bmj.com/content/70/4/698.abstract
AB 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.Data are available in a public, open access repository. https://www.ncbi.nlm.nih.gov/bioproject/PRJNA650244. Raw sequence data are available in the Sequence Read Archive (SRA) under BioProject accession PRJNA650244.