Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Respiratory and Critical Care Medicine, Xinyang Fifth People's Hospital, Xinyang, China.
Ann Palliat Med. 2021 Dec;10(12):12374-12380. doi: 10.21037/apm-21-3373.
To examine the incidence of diarrhea in severe and critical coronavirus disease 2019 (COVID-19) patients, and to observe the efficacy and prognosis of probiotic use in such patients.
A retrospective study was conducted to investigate the symptoms and incidence of diarrhea in 156 cases of COVID-19 confirmed by the First Affiliated Hospital of Zhengzhou University and the Xinyang Fifth People's Hospital, China. A total of 58 cases of severe and critical COVID-19 were identified and divided into the treatment group or the control group. The control group was given standard treatment according to the Protocols for Diagnosis and Treatment of COVID-19: Prevention, Control, Diagnosis and Management. Patients in the treatment group were administered oral probiotics as well as the standard treatment. The 2 groups were compared in terms of nutritional status (serum albumin), improvement of diarrhea symptoms, changes in inflammatory condition [procalcitonin (PCT) and C-reactive protein (CRP)], the time taken to register a negative result for respiratory tract pathogens on the nucleic acid test, and changes to white blood cell and lymphocyte cell counts.
In this study cohort, diarrhea was detected in 15.38% (24/156) of COVID-19 patients. The incidence of diarrhea in patients with mild and moderate COVID-19 was approximately 8.16% (8/98), and the incidence of diarrhea in severe and critically ill patients was approximately 27.59% (16/58). In patients with severe and critical COVID-19, probiotic treatment obviously shortened the duration of diarrhea. Furthermore, compared with the control group, patients treated with probiotics showed a significantly reduced time to achieving a negative nucleic acid test and the inflammation indexes including PCT and CRP were significantly reduced (P<0.05).
The incidence of diarrhea in severe and critically ill COVID-19 patients was significantly higher than that in patients with mild and moderate COVID-19. Probiotics may have a good supporting role in the treatment of patients with COVID-19 and its early application is recommended.
研究严重和危重新冠病毒病 2019（COVID-19）患者腹泻的发生率，并观察益生菌在这类患者中的使用效果和预后。
对中国郑州大学第一附属医院和信阳第五人民医院确诊的 156 例 COVID-19 患者的症状和腹泻发生率进行回顾性研究。共确定 58 例严重和危重新冠肺炎患者，并分为治疗组或对照组。对照组按照《COVID-19 诊疗方案：预防、控制、诊断和管理》给予标准治疗。治疗组患者给予口服益生菌和标准治疗。比较两组患者的营养状况（血清白蛋白）、腹泻症状改善情况、炎症情况（降钙素原（PCT）和 C 反应蛋白（CRP））变化、呼吸道病原体核酸检测转阴时间以及白细胞和淋巴细胞计数变化。
在本研究队列中，156 例 COVID-19 患者中检测到腹泻，占 15.38%（24/156）。轻度和中度 COVID-19 患者的腹泻发生率约为 8.16%（8/98），严重和危重症患者的腹泻发生率约为 27.59%（16/58）。在严重和危重新冠肺炎患者中，益生菌治疗明显缩短了腹泻持续时间。此外，与对照组相比，益生菌治疗组患者达到核酸检测阴性的时间明显缩短，PCT 和 CRP 等炎症指标明显降低（P<0.05）。
严重和危重新冠肺炎患者的腹泻发生率明显高于轻度和中度 COVID-19 患者。益生菌可能在 COVID-19 患者的治疗中发挥良好的支持作用，建议早期应用。
