Clinical implications of gut microbiota and cytokine responses in coronavirus disease prognosis
Hye Seong, Jun Hyoung Kim, Young-Hee Han, Ho Seong Seo, Hakjun Hyun, Jin Gu Yoon, Eliel Nham, Ji Yun Noh, Hee Jin Cheong, Woo Joo Kim, Sooyeon Lim, Joon Young Song
Abstract
Objectives Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects gut luminal cells through the angiotensin-converting enzyme-2 receptor and disrupts the gut microbiome. We investigated whether the gut microbiome in the early stage of SARS-CoV-2 infection was associated with the prognosis of coronavirus disease (COVID-19). Methods Thirty COVID-19 patients and 16 healthy controls were prospectively enrolled. Blood and stool samples and clinical details were collected on days 0 (enrollment), 7, 14, and 28. Participants were categorized into four groups by their clinical course. Results Gut microbiota composition varied during the clinical course of COVID-19 and was closely associated with cytokine levels ( p =0.003). A high abundance of the genus Dialister (linear discriminant analysis [LDA] effect size: 3.97856, p =0.004), species Peptoniphilus lacrimalis (LDA effect size: 4.00551, p =0.020), and Anaerococcus prevotii (LDA effect size: 4.00885, p =0.007) was associated with a good prognosis. Starch, sucrose, and galactose metabolism was highly activated in the gut microbiota of the poor prognosis group. Glucose-lowering diets, including whole grains, were positively correlated with a good prognosis. Conclusion Gut microbiota may mediate the prognosis of COVID-19 by regulating cytokine responses and controlling glucose metabolism, which is implicated in the host immune response to SARS-CoV-2.