Department of Surgical Oncology, Medical University of Gdansk, Gdansk, Poland.
Eur Rev Med Pharmacol Sci. 2020 Oct;24(20):10853-10859. doi: 10.26355/eurrev_202010_23448.
The aim of this review paper was to discuss the gut microbiota-related aspects of COVID-19 patients. We presented the faecal-oral transmission of SARS-CoV-2, gut microbiota imbalance, and fecal microbiota transplantation as a hidden source of this virus.
We analyzed the available literature (PubMed, Embase, Google Scholar databases) regarding COVID-19 and gut microbiota related aspects.
The gastrointestinal symptoms, such as nausea, vomiting, diarrhea, abdominal discomfort/pain, may occur in these patients. Notably, these symptoms may contribute to the severity of COVID-19. Recent several studies have revealed a new SARS-CoV-2 transmission possibility, opening a fresh view on COVID-19. It is observed the possibility of SARS-CoV-2 transmission via faecal-oral route. Fecal microbiota transplantation may be a hidden source of SARS-CoV-2. Additionally, the pharmacological treatment of COVID-19 and other factors may significantly alter the composition of gut microbiota. Among others, loss of bacterial diversity, the decrease of commensal microbes as well as the increase of opportunistic pathogens are observed.
The alterations of gut microbiota in COVID-19 patients consequently may lead to the development of gut dysbiosis-related diseases even after recovery from COVID-19. Therefore, it is recommended to screen stool samples taken from recovered patients at least 35 days after clearance of virus from respiratory tract. Before 35 days period, SARS-CoV-2 may still be detected in feces. It is also recommended to screen the composition as well as the activity of gut microbiota to assess its balance. In the case of gut dysbiosis, there should be introduced an appropriate method of its modulation. Additionally, all the fecal samples which are prepared for fecal microbiota transplantation should be tested for SARS-CoV-2 to provide protection for its recipients.
本文旨在讨论 COVID-19 患者的肠道微生物群相关方面。我们提出了 SARS-CoV-2 的粪-口传播、肠道微生物群失衡以及粪便微生物群移植作为该病毒的隐藏来源。
我们分析了关于 COVID-19 和肠道微生物群相关方面的现有文献（PubMed、Embase、Google Scholar 数据库）。
这些患者可能出现胃肠道症状，如恶心、呕吐、腹泻、腹部不适/疼痛等。值得注意的是，这些症状可能导致 COVID-19 的严重程度增加。最近的几项研究揭示了 SARS-CoV-2 传播的新可能性，为 COVID-19 提供了新的视角。观察到 SARS-CoV-2 经粪-口途径传播的可能性。粪便微生物群移植可能是 SARS-CoV-2 的隐藏来源。此外，COVID-19 的药物治疗和其他因素可能会显著改变肠道微生物群的组成。例如，观察到细菌多样性丧失、共生微生物减少以及机会性病原体增加。
COVID-19 患者的肠道微生物群改变可能导致肠道微生态失调相关疾病的发生，即使在从 COVID-19 中康复后也是如此。因此，建议至少在呼吸道病毒清除后 35 天从康复患者中筛选粪便样本。在 35 天之前，粪便中仍可能检测到 SARS-CoV-2。还建议筛选肠道微生物群的组成和活性以评估其平衡。在出现肠道微生态失调的情况下，应引入适当的调节方法。此外，应测试所有准备用于粪便微生物群移植的粪便样本以检测 SARS-CoV-2，为其接受者提供保护。
