Microbiota and intestinal permeability as drivers of gastroenterological manifestations of new coronavirus infection (COVID-19)
https://doi.org/10.22625/2072-6732-2021-13-4-57-65
Abstract
An important area of effective control of the COVID-19 pandemic is the study of the pathogenetic features of SARSCoV-2 infection, including those based on the assessment of the state of the microbiota and intestinal permeability.
Purpose: To study the clinical features of the new coronavirus infection (COVID-19) in patients of mild and moderate severity at the stage of hospitalization, to determine the role of intestinal permeability disorders, changes in the qualitative and quantitative composition of the microbiota in the formation of systemic inflammation in COVID-19 patients.
Material and methods: The study was performed in 80 patients with COVID-19, whose average age was 45 years, 19 of them had mild and 61 had moderate severity of the disease. The scope of the examination included traditional clinical, clinical and laboratory, biochemical, instrumental and radiation studies, as well as original methods for studying microbiota and intestinal permeability.
Results and conclusions: Clinical features of the course of COVID-19 were studied, clinical and biochemical features, manifestations of systemic inflammation, changes in the intestinal microbiome of patients with mild and moderate severity were identified, concentration levels of proinflammatory cytokines, insulin, fecal calprotectin and zonulin were determined, reflecting the features of intestinal permeability against the background of COVID-19. The role of intestinal permeability and microbiota as the main drivers of the development of gastroenterological manifestations of COVID-19, accompanied by a more severe course of the disease, is emphasized.
About the Authors
K. V. Kozlov
Military Medical Academy named after S.M. Kirov
Russian Federation
Russian Federation
Saint-Petersburg
A. K. Ratnikova
North-Western District Scientific and Clinical Center named after L.G. Sokolov;
«Pervaya Liniya», Health Care Resort
Russian Federation
Russian Federation
Saint-Petersburg
V. B. Grinevich
Military Medical Academy named after S.M. Kirov
Russian Federation
Russian Federation
Saint-Petersburg
Yu. A. Kravchuk
Military Medical Academy named after S.M. Kirov
Russian Federation
Russian Federation
Saint-Petersburg
P. I. Miklush
Military Medical Academy named after S.M. Kirov
Russian Federation
Russian Federation
Saint-Petersburg
References
1. Yakovenko, E. P. Патология пищеварительного тракта и печени при COVID-19 / E. P. Yakovenko, A. V. Yakovenko, A. N. Ivanov [и др.] // Experimental and clinical gastroenterology. – 2020. – Vol. 176, N 4. – P. 19-23.
2. Huang, C. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China / C. Huang, Y. Wang , X. Li [et al.] // Lancet. – 2020. – Vol. 395, №10223. – P. 497–506.
3. Giron, L. Plasma markers of disrupted gut permeability in severe COVID-19 patients / L. Giron, H. Dweep, X. Yin [et al.] // Front. Immunol. – 2021. – Vol. 12, N 686240. – P. 1-16.
4. Ahlawat, S. Immunological co-ordination between gut and lungs in SARS-CoV-2 infection / S. Ahlawat, Asha, K. K. Sharma // Virus Research. – 2020. – Vol. 286. – P. 1-10.
5. Troisi, J. COVID-19 and the gastrointestinal tract: Source of infection or merely a target of the inflammatory process following SARS-CoV-2 infection? / J. Troisi, G. Venutolo, M. P. Tanyà [et al.] // World J. Gastroenterol. – 2021. – Vol. 27, N 14. – P. 1406–1418.
6. Fasano, A. Intestinal permeability and its regulation by zonulin: diagnostic and therapeutic implications /A. Fasano // Clinical Gastroenterol. Hepatol. – 2012. – Vol. 10, N 8. – P. 1096-1100.
7. Llorens, S. Neurological symptoms of COVID-19: the zonulin hypothesis / S. Llorens, E. Nava, M. Muñoz-López [et al.] // Front. Immunol. – 2021. – Vol. 12. – N 665300. - P. 1-9
8. Di Micco, S. Peptide derivatives of the zonulin inhibitor larazotide (AT1001) as potential anti SARS-CoV-2: molecular modelling, synthesis and bioactivity evaluation / S. Di Micco, S. Musella, M. Sala [et al.] // Intern. J. Molec. Sci. – 2021. – Vol.22, N 17. – P. 9427.
9. Leffler, D. A. Larazotide acetate for persistent symptoms of celiac disease despite a gluten-free diet: a randomized controlled trial / D. A. Leffler, C. P. Kelly, P. H. Green [et al.] // Gastroenterol. – 2015. – Vol. 148, N 7. – P. 1311–1319.
10. Oliva, A. Low-grade endotoxemia and thrombosis in COVID-19 / A. Oliva, V. Cammisotto, R. Cangemi [et al.] // Clin. Translat. Gastroenterol. – 2021. – Vol. 12, N 6. – P. 1-6.
11. Giron, L. B. Severe COVID-19 is fueled by disrupted gut barrier integrity / L. B. Giron; H. Dweep; X. Yin [et al.] // Topics in Antiviral Medicine. – 2021. – Vol. 29, N 1. – P. 29-30.
12. Guan, W. J. Clinical characteristics of coronavirus disease 2019 in China / W.J. Guan, Z. Ni, Y. Hu [et al.] // J Emerg Med. – 2020. – Vol. 58, N 4. – P. 711-712.
13. Tao, Z. Alterations in gut microbiota of patients with COVID-19 during time of hospitalization / Z. Tao, F. Zhang, G. Lui [et al.] // Gastroenterol. – 2020. – Vol. 159, N 3. – P. 944–955.
14. Yeoh, K. Y. Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19 / K. Y. Yeoh, T. Zuo, G. C. Lui [et al.] // Gut. – 2021. – Vol. 70, N 4. – P. 698–706.
15. Temporary methodological recommendations. Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19). Version-7 (03.06.2020). - Moscow: Ministry of Health of the Russian Federation, 2020. - 166 p.
16. Kordzadeh-Kermani, E. Pathogenesis, clinical manifestations and complications of coronavirus disease 2019 (COVID-19) / E. Kordzadeh-Kermani, H. Khalili, I. Karimzadeh // Future Microbiol. – 2020. – Vol. 15, N 5. – P. 1287-1305.
17. Zhou, Z. Effect of gastrointestinal symptoms in patients with COVID-19 / Z. Zhou, N. Zhao, Y. Shu [et al.] // Gastroenterology. – 2020. – Vol. 158, N 8. – P. 2294-2297.
18. Rismanbaf, A. Liver and kidney injuries in COVID-19 and their effects on drug therapy; a letter to editor / A. Rismanbaf, S. Zarei // Arch. Acad. Emerg. Med. – 2020. – Vol. 8, N 1. – P. 17.
19. Zheng, M. Functional exhaustion of antiviral lymphocytes in COVID-19 patients / M. Zheng, Y. Gao, G. Wang [et al.] // Cell. Mol. Immunol. – 2020. – Vol. 17, N 5. – P. 533–535.
20. Wang, W. Definition and Risks of Cytokine Release Syndrome in 11 Critically Ill COVID-19 Patients With Pneumonia: Analysis of Disease Characteristics / W. Wang, X. Liu, S. Wu // J Infect Dis. – 2020. – Vol. 222, N 9. – P. 1444-1451.
21. Gao, Q. Y. 2019 novel coronavirus infection and gastrointestinal tract / Q. Y. Gao, Y. X. Chen, J. Y. Fang // J. Dig. Dis. – 2020. – Vol. 21, N 3. – P. 125–126.
22. He, Y. Gut–lung axis: the microbial contributions and clinical implications / Y. He, Q. Wen, F. Yao [et al.] // Crit. Rev. Microbiol. – 2017. – Vol. 43, N 1. – P. 81-95.
23. Simanenkov, V. I. Syndrome of increased epithelial permeability in clinical practice. Multidisciplinary national Consensus. Cardiovascular Therapy and Prevention / V. I. Simanenkov, I. V. Maev, O. N. Tkacheva [et al.] // Cardiovascular Therapy and Prevention. – 2021. - Vol. 20, N 1 – P. 121-278.
24. Ahlawat, S. Gut–organ axis: a microbial outreach and networking / S. Ahlawat, Asha, K. K. Sharma // Lett. Appl. Microbiol. – 2020. – Vol. 72, N 6. – P. 636-668.
Review
For citations:
Kozlov K.V., Ratnikova A.K., Grinevich V.B., Kravchuk Yu.A., Miklush P.I. Microbiota and intestinal permeability as drivers of gastroenterological manifestations of new coronavirus infection (COVID-19). Journal Infectology. 2021;13(4):57-65. (In Russ.) https://doi.org/10.22625/2072-6732-2021-13-4-57-65
Views:
794
.png)
.png)
Email this article 