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January 26, 2022
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Susceptibility to long-term COVID-19 complications linked to gut microbiome profile

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Alterations to the composition of the gut microbiome were found in patients with long-term complications of COVID-19, according to study results published in Gut.

“[Altered] gut microbiome composition is strongly associated with persistent symptoms in patients with COVID-19 up to 6 months after clearance of SARS-CoV-2 virus,” Qin Liu, PhD, from the Center for Gut Microbiota Research at The Chinese University of Hong Kong, and colleagues wrote. “Considering the millions of people infected during the ongoing pandemic, our findings are a strong impetus for consideration of microbiota modulation to facilitate timely recovery and reduce the burden of post-acute COVID-19 syndrome.”

In a prospective study, Liu and colleagues recruited 106 patients with varying degrees of COVID-19 severity and 68 non-COVID-19 controls. Investigators used shotgun metagenomic sequencing to assess serial fecal microbiome of 258 samples, and comparedthe results with persistent symptoms at 6 months.

According to study results, 76% of patients had post-acute COVID-19 syndrome at 6 months, which included fatigue, poor memory and hair loss. Investigators identified a correlation between gut microbiota composition at admission and the occurrence of post-acute COVID-19 syndrome, noting that patients without post-acute COVID-19 syndrome had a similar recovered gut microbiome profile at 6 months to that of non-COVID-19 controls. Higher levels of Ruminococcus gnavus, Bacteroides vulgatus were observed in the gut microbiome of patients with post-acute COVID-19 syndrome; however, investigators noted lower levels of Faecalibacterium prausnitzii.

In addition, persistent respiratory symptoms were associated with opportunistic gut pathogens, and neuropsychiatric symptoms and fatigue were associated with nosocomial gut pathogens, including Clostridium innocuum and Actinomyces naeslundii (all P < .05).

Researchers also found that at 6 months, butyrate-producing bacteria, such as Bifidobacterium pseudocatenulatum and Faecalibacterium prausnitzii, demonstrated the largest inverse association with post-acute COVID-19 syndrome.

“These findings provide new insights into the intricate association between the gut microbiome and the long-term sequelae after COVID-19 infection,” Liu and colleagues wrote. “Microbiome-based profiling might be used as a tool in early risk stratification for occurrence of post-acute COVID-19 syndrome.”