PT  - JOURNAL ARTICLE
AU  - Qin Liu
AU  - Joyce Wing Yan Mak
AU  - Qi Su
AU  - Yun Kit Yeoh
AU  - Grace Chung-Yan Lui
AU  - Susanna So Shan Ng
AU  - Fen Zhang
AU  - Amy Y L Li
AU  - Wenqi Lu
AU  - David Shu-Cheong Hui
AU  - Paul KS Chan
AU  - Francis K L Chan
AU  - Siew C Ng
TI  - Gut microbiota dynamics in a prospective cohort of patients with post-acute COVID-19 syndrome
AID  - 10.1136/gutjnl-2021-325989
DP  - 2022 Mar 01
TA  - Gut
PG  - 544--552
VI  - 71
IP  - 3
4099  - http://gut.bmj.com/content/71/3/544.short
4100  - http://gut.bmj.com/content/71/3/544.full
SO  - Gut2022 Mar 01; 71
AB  - Background Long-term complications after COVID-19 are common, but the potential cause for persistent symptoms after viral clearance remains unclear.Objective To investigate whether gut microbiome composition is linked to post-acute COVID-19 syndrome (PACS), defined as at least one persistent symptom 4 weeks after clearance of the SARS-CoV-2 virus.Methods We conducted a prospective study of 106 patients with a spectrum of COVID-19 severity followed up from admission to 6 months and 68 non-COVID-19 controls. We analysed serial faecal microbiome of 258 samples using shotgun metagenomic sequencing, and correlated the results with persistent symptoms at 6 months.Results At 6 months, 76% of patients had PACS and the most common symptoms were fatigue, poor memory and hair loss. Gut microbiota composition at admission was associated with occurrence of PACS. Patients without PACS showed recovered gut microbiome profile at 6 months comparable to that of non-COVID-19 controls. Gut microbiome of patients with PACS were characterised by higher levels of Ruminococcus gnavus, Bacteroides vulgatus and lower levels of Faecalibacterium prausnitzii. Persistent respiratory symptoms were correlated with opportunistic gut pathogens, and neuropsychiatric symptoms and fatigue were correlated with nosocomial gut pathogens, including Clostridium innocuum and Actinomyces naeslundii (all p<0.05). Butyrate-producing bacteria, including Bifidobacterium pseudocatenulatum and Faecalibacterium prausnitzii showed the largest inverse correlations with PACS at 6 months.Conclusion These findings provided observational evidence of compositional alterations of gut microbiome in patients with long-term complications of COVID-19. Further studies should investigate whether microbiota modulation can facilitate timely recovery from post-acute COVID-19 syndrome.Data are available in a public, open access repository. Raw data are deposited in a BioProject in the NCBI Sequence Read Archive: PRJNA714459.