Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary Therapeutic Strategy to Avoid the Progression of COVID-19

Frontiers in Medicine

article

Gabriella d'Ettorre¹  Carolina Scagnolari²  Cristina Mastropietro¹  Vito Trinchieri¹  Gregorio Egidio Recchia¹  Vera Mauro¹  Guido Antonelli²  Francesco Pugliese³  Claudio Maria Mastroianni¹  Giancarlo Ceccarelli¹  Massimiliano Marazzato¹  Giuseppe Campagna⁴  Claudia Pinacchio¹  Francesco Alessandri³  Franco Ruberto³  Giacomo Rossi⁵  Luigi Celani¹ 

[1] Department of Public Health and Infectious Diseases, Sapienza University of Rome;Laboratory of Virology, Department of Molecular Medicine, Affiliated to Istituto Pasteur Italia - Cenci Bolognetti Foundation, Sapienza University;Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome;Department of Clinical and Molecular Medicine, Sapienza University of Rome;School of Biosciences, Veterinary Medicine University of Camerino

关键词: COVID-19;    SARS-CoV-2;    bacteriotherapy;    probiotic;    lactobacillus;    gut-lung axis;    gut;   

DOI  :  10.3389/fmed.2020.00389

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: Gastrointestinal disorders are frequent in COVID-19 and SARS-CoV-2 has been hypothesized to impact on host microbial flora and gut inflammation, infecting intestinal epithelial cells. Since there are currently no coded therapies or guidelines for treatment of COVID-19, this study aimed to evaluate the possible role of a specific oral bacteriotherapy as complementary therapeutic strategy to avoid the progression of COVID-19. Methods: We provide a report of 70 patients positive for COVID-19, hospitalized between March 9th and April 4th, 2020. All the patients had fever, required non-invasive oxygen therapy and presented a CT lung involvement on imaging more than 50%. Forty-two patients received hydroxychloroquine, antibiotics, and tocilizumab, alone or in combination. A second group of 28 subjects received the same therapy added with oral bacteriotherapy, using a multistrain formulation. Results: The two cohorts of patients were comparable for age, sex, laboratory values, concomitant pathologies, and the modality of oxygen support. Within 72 h, nearly all patients treated with bacteriotherapy showed remission of diarrhea and other symptoms as compared to less than half of the not supplemented group. The estimated risk of developing respiratory failure was eight-fold lower in patients receiving oral bacteriotherapy. Both the prevalence of patients transferred to ICU and mortality were higher among the patients not treated with oral bacteriotherapy. Conclusions: A specific bacterial formulation showed a significant ameliorating impact on the clinical conditions of patients positive for SARS-CoV-2 infection. These results also stress the importance of the gut-lung axis in controlling the COVID-19 disease.

【 授权许可】

CC BY