State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Department of Infectious Diseases, Shulan (Hangzhou) Hospital, affiliated to Shulan International Medical College, Zhejiang Shuren University, Hangzhou, China.
Clin Infect Dis. 2020 Dec 17;71(10):2669-2678. doi: 10.1093/cid/ciaa709.
Coronavirus disease 2019 (COVID-19) is an emerging serious global health problem. Gastrointestinal symptoms are common in COVID-19 patients, and severe acute respiratory syndrome coronavirus 2 RNA has been detected in stool specimens. However, the relationship between the gut microbiome and disease remains to be established.
We conducted a cross-sectional study of 30 patients with COVID-19, 24 patients with influenza A(H1N1), and 30 matched healthy controls (HCs) to identify differences in the gut microbiota by 16S ribosomal RNA gene V3-V4 region sequencing.
Compared with HCs, COVID-19 patients had significantly reduced bacterial diversity; a significantly higher relative abundance of opportunistic pathogens, such as Streptococcus, Rothia, Veillonella, and Actinomyces; and a lower relative abundance of beneficial symbionts. Five biomarkers showed high accuracy for distinguishing COVID-19 patients from HCs with an area under the curve (AUC) up to 0.89. Patients with H1N1 displayed lower diversity and different overall microbial composition compared with COVID-19 patients. Seven biomarkers were selected to distinguish the 2 cohorts (AUC = 0.94).
The gut microbial signature of patients with COVID-19 was different from that of H1N1 patients and HCs. Our study suggests the potential value of the gut microbiota as a diagnostic biomarker and therapeutic target for COVID-19, but further validation is needed.
2019 年冠状病毒病（COVID-19）是一个新出现的严重全球卫生问题。COVID-19 患者常有胃肠道症状，粪便标本中已检测到严重急性呼吸综合征冠状病毒 2 型 RNA。然而，肠道微生物组与疾病的关系仍有待确定。
我们对 30 例 COVID-19 患者、24 例甲型 H1N1 流感患者和 30 名匹配的健康对照者（HC）进行了横断面研究，通过 16S 核糖体 RNA 基因 V3-V4 区测序来鉴定肠道微生物组的差异。
与 HCs 相比，COVID-19 患者的细菌多样性显著降低；机会性病原体（如链球菌、罗氏菌、韦荣球菌和放线菌）的相对丰度显著升高；有益共生体的相对丰度降低。5 种生物标志物对区分 COVID-19 患者和 HCs 具有很高的准确性，曲线下面积（AUC）高达 0.89。与 COVID-19 患者相比，H1N1 患者的多样性较低，整体微生物组成不同。选择 7 种生物标志物来区分这 2 个队列（AUC = 0.94）。
COVID-19 患者的肠道微生物特征与 H1N1 患者和 HCs 不同。我们的研究表明，肠道微生物组作为 COVID-19 的诊断生物标志物和治疗靶点具有潜在价值，但需要进一步验证。
