Rapid resolution of COVID-19 after faecal microbiota transplantation
Jarosław Biliński, Katarzyna Winter, Marcin Jasiński, Anna Szczęś, Natalia Bilinska, Benjamin H. Mullish, Ewa Małecka‐Panas, Grzegorz Basak
Abstract
Recent publications demonstrate that SARS-CoV-2 may undergo prolonged shedding in stool, and that gut microbiome perturbations associate with COVID-19 severity.1 2 Faecal microbiota transplant (FMT) restores a damaged gut microbiome and may impact on immune responses,3 including in the respiratory system (‘gut–lung axis’)4; such microbiome-immune signalling may result in lung-epithelial resistance to SARS-CoV-2.5 We describe two interesting cases of patients treated with FMT primarily to treat Clostridioides difficile infection (CDI), but which coincidentally were performed just before initial symptoms of coexisting COVID-19 (figure 1). Figure 1 Timeline of the procedures performed in patients with CDI, which coincidentally occurred during COVID-19 early stage infection. Created with BioRender.com. CDI, Clostridioides difficile infection; ESBL, extended-spectrum beta-lactamase, FMT, faecal microbiota transplant. Patient 1: an 80-year-old man with multiple comorbidities, including prior CDI, was admitted to hospital with pneumonia/sepsis. Following meropenem treatment, pneumonic features resolved, but CDI relapse occurred. Sequential vancomycin treatment and nasojejunal FMT were administered. On the day of FMT, he …