Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
Comprehensive Medical Treatment Ward, Nanfang Hospital, Southern Medical University, Guangzhou, China.
mSystems. 2024 Jun 18;9(6):e0018524. doi: 10.1128/msystems.00185-24. Epub 2024 May 3.
Acute ischemic stroke (AIS) patients with active COVID-19 infection often have more severe symptoms and worse recovery. COVID-19 infection can cause gut microbiota dysbiosis, which is also a risk factor for poor outcomes in AIS patients. However, the association between gut microbiota and functional outcomes among AIS patients with COVID-19 infection has not been fully clarified yet. In this study, we performed 16S rRNA gene sequencing to characterize the gut microbial community among AIS patients with acute COVID-19 infection, AIS patients with post-acute COVID-19 infection, and AIS patients without COVID-19 infection. We found that AIS patients with acute COVID-19 experienced poorer recovery and significant gut dysbiosis, characterized by higher levels of and lower levels of and . Furthermore, a shorter time window (less than 28 days) between COVID-19 infection and stroke was identified as a risk factor for poor functional outcomes in AIS patients with COVID-19, and the enrichment of was indicated as a mediator in the relationship between infection time window and poor stroke outcomes. Our findings highlight the importance of early intervention after COVID-19 infection, especially by regulating the gut microbiota, which plays a role in the prognosis of AIS patients with COVID-19 infection.IMPORTANCEThe gut microbiota plays an important role in the association between respiratory system and cerebrovascular system through the gut-lung axis and gut-brain axis. However, the specific connection between gut bacteria and the functional outcomes of acute ischemic stroke (AIS) patients with COVID-19 is not fully understood yet. In our study, we observed a significant decrease in bacterial diversity and shifts in the abundance of key bacterial families in AIS patients with acute COVID-19 infection. Furthermore, we identified that the time window was a critical influence factor for stroke outcomes, and the enrichment of acted as a mediator in the relationship between the infection time window and poor stroke outcomes. Our research provides a new perspective on the complex interplay among AIS, COVID-19 infection, and gut microbiota dysbiosis. Moreover, recognizing as a potential mediator of poor stroke prognosis offers a novel avenue for future exploration and therapeutic interventions.
急性缺血性脑卒中（AIS）合并活动期 COVID-19 感染的患者通常症状更严重，恢复更差。COVID-19 感染可导致肠道菌群失调，这也是 AIS 患者预后不良的危险因素。然而，COVID-19 感染的 AIS 患者肠道菌群与功能结局之间的关系尚未完全阐明。在这项研究中，我们对急性 COVID-19 感染、急性 COVID-19 后感染和无 COVID-19 感染的 AIS 患者进行了 16S rRNA 基因测序，以描述肠道微生物群落。我们发现急性 COVID-19 感染的 AIS 患者恢复较差，肠道严重失调，表现为 水平升高， 和 水平降低。此外，COVID-19 感染与中风之间的时间窗较短（<28 天）被确定为 COVID-19 感染的 AIS 患者功能结局不良的危险因素，而 的富集被认为是感染时间窗与不良中风结局之间关系的中介。我们的研究结果强调了 COVID-19 感染后早期干预的重要性，特别是通过调节肠道微生物群来改善 COVID-19 感染的 AIS 患者的预后。
意义：肠道微生物群通过肺肠轴和肠脑轴在呼吸系统和脑血管系统之间的关联中起着重要作用。然而，肠道细菌与 COVID-19 感染的急性缺血性脑卒中（AIS）患者功能结局之间的具体联系尚未完全了解。在我们的研究中，我们观察到急性 COVID-19 感染的 AIS 患者的细菌多样性显著降低，关键细菌家族的丰度发生变化。此外，我们发现时间窗是影响中风结局的关键因素， 的富集在感染时间窗与不良中风结局之间的关系中起中介作用。我们的研究为 AIS、COVID-19 感染和肠道菌群失调之间的复杂相互作用提供了一个新的视角。此外，将 鉴定为不良中风预后的潜在介导物为未来的探索和治疗干预提供了一个新的途径。
