Zhong Jiaxin, Guo Li, Wang Yeming, Jiang Xuan, Wang Chun, Xiao Yan, Wang Ying, Zhou Fei, Wu Chao, Chen Lan, Wang Xinming, Wang Jianwei, Cao Bin, Li Mingkun, Ren LiLi
Beijing Institute of Genomics, Chinese Academy of Sciences, and China National Center for Bioinformation, Beijing, China.
University of Chinese Academy of Sciences, Beijing, China.
Research (Wash D C). 2024 May 22;7:0389. doi: 10.34133/research.0389. eCollection 2024.
The gut microbiota undergoes substantial changes in COVID-19 patients; yet, the utility of these alterations as prognostic biomarkers at the time of hospital admission, and its correlation with immunological and hematological parameters, remains unclear. The objective of this study is to investigate the gut microbiota's dynamic change in critically ill patients with COVID-19 and evaluate its predictive capability for clinical outcomes alongside immunological and hematological parameters. In this study, anal swabs were consecutively collected from 192 COVID-19 patients (583 samples) upon hospital admission for metagenome sequencing. Simultaneously, blood samples were obtained to measure the concentrations of 27 cytokines and chemokines, along with hematological and biochemical indicators. Our findings indicate a significant correlation between the composition and dynamics of gut microbiota with disease severity and mortality in COVID-19 patients. Recovered patients exhibited a higher abundance of and denser interactions among gut commensal bacteria compared to deceased patients. Furthermore, the abundance of gut commensal bacteria exhibited a negative correlation with the concentration of proinflammatory cytokines and organ damage markers. The gut microbiota upon admission showed moderate prognostic prediction ability with an AUC of 0.78, which was less effective compared to predictions based on immunological and hematological parameters (AUC 0.80 and 0.88, respectively). Noteworthy, the integration of these three datasets yielded a higher predictive accuracy (AUC 0.93). Our findings suggest the gut microbiota as an informative biomarker for COVID-19 prognosis, augmenting existing immune and hematological indicators.
新冠病毒肺炎患者的肠道微生物群会发生显著变化；然而，这些改变在入院时作为预后生物标志物的效用及其与免疫和血液学参数的相关性仍不明确。本研究的目的是调查重症新冠病毒肺炎患者肠道微生物群的动态变化，并评估其与免疫和血液学参数一起对临床结局的预测能力。在本研究中，对192例新冠病毒肺炎患者（583份样本）入院时连续采集肛门拭子进行宏基因组测序。同时，采集血样以测量27种细胞因子和趋化因子的浓度以及血液学和生化指标。我们的研究结果表明，新冠病毒肺炎患者肠道微生物群的组成和动态变化与疾病严重程度和死亡率之间存在显著相关性。与死亡患者相比，康复患者肠道共生菌的丰度更高，相互作用更密集。此外，肠道共生菌的丰度与促炎细胞因子浓度和器官损伤标志物呈负相关。入院时的肠道微生物群显示出中等的预后预测能力，曲线下面积（AUC）为0.78，与基于免疫和血液学参数的预测（AUC分别为0.80和0.88）相比效果较差。值得注意的是，这三个数据集的整合产生了更高的预测准确性（AUC为0.93）。我们的研究结果表明，肠道微生物群是新冠病毒肺炎预后的一个信息丰富的生物标志物，可增强现有的免疫和血液学指标。
