d'Ettorre Gabriella, Ceccarelli Giancarlo, Marazzato Massimiliano, Campagna Giuseppe, Pinacchio Claudia, Alessandri Francesco, Ruberto Franco, Rossi Giacomo, Celani Luigi, Scagnolari Carolina, Mastropietro Cristina, Trinchieri Vito, Recchia Gregorio Egidio, Mauro Vera, Antonelli Guido, Pugliese Francesco, Mastroianni Claudio Maria
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.
Front Med (Lausanne). 2020 Jul 7;7:389. doi: 10.3389/fmed.2020.00389. eCollection 2020.
Gastrointestinal disorders are frequent in COVID-19 and SARS-CoV-2 has been hypothesized to impact on host microbial flora and gut inflammation, infecting intestinal epithelial cells. Since there are currently no coded therapies or guidelines for treatment of COVID-19, this study aimed to evaluate the possible role of a specific oral bacteriotherapy as complementary therapeutic strategy to avoid the progression of COVID-19. We provide a report of 70 patients positive for COVID-19, hospitalized between March 9th and April 4th, 2020. All the patients had fever, required non-invasive oxygen therapy and presented a CT lung involvement on imaging more than 50%. Forty-two patients received hydroxychloroquine, antibiotics, and tocilizumab, alone or in combination. A second group of 28 subjects received the same therapy added with oral bacteriotherapy, using a multistrain formulation. The two cohorts of patients were comparable for age, sex, laboratory values, concomitant pathologies, and the modality of oxygen support. Within 72 h, nearly all patients treated with bacteriotherapy showed remission of diarrhea and other symptoms as compared to less than half of the not supplemented group. The estimated risk of developing respiratory failure was eight-fold lower in patients receiving oral bacteriotherapy. Both the prevalence of patients transferred to ICU and mortality were higher among the patients not treated with oral bacteriotherapy. A specific bacterial formulation showed a significant ameliorating impact on the clinical conditions of patients positive for SARS-CoV-2 infection. These results also stress the importance of the gut-lung axis in controlling the COVID-19 disease.
胃肠道疾病在新冠肺炎中很常见，并且有假说认为严重急性呼吸综合征冠状病毒2（SARS-CoV-2）会影响宿主微生物菌群和肠道炎症，感染肠道上皮细胞。由于目前尚无针对新冠肺炎的编码治疗方法或治疗指南，本研究旨在评估一种特定的口服细菌疗法作为辅助治疗策略以避免新冠肺炎病情进展的可能作用。我们报告了70例新冠肺炎阳性患者，他们于2020年3月9日至4月4日期间住院。所有患者均有发热，需要无创氧疗，且肺部CT影像显示肺部受累超过50%。42例患者单独或联合接受了羟氯喹、抗生素和托珠单抗治疗。第二组28名受试者接受了相同治疗，并添加了使用多菌株制剂的口服细菌疗法。两组患者在年龄、性别、实验室检查值、合并疾病以及氧疗方式方面具有可比性。在72小时内，与未补充细菌疗法组不到一半的患者相比，几乎所有接受细菌疗法治疗的患者腹泻和其他症状均有所缓解。接受口服细菌疗法的患者发生呼吸衰竭的估计风险降低了八倍。未接受口服细菌疗法的患者转入重症监护病房（ICU）的比例和死亡率均较高。一种特定的细菌制剂对SARS-CoV-2感染阳性患者的临床状况产生了显著的改善作用。这些结果也强调了肠-肺轴在控制新冠肺炎疾病中的重要性。
