Long Covid and gut microbiotic changes

[jim mcnamara]

TL;DR Summary

Preliminary study that found an association with permanent changes in the composition of gut microbiota and persistence of long Covid symptoms.

https://gut.bmj.com/content/early/2022/01/05/gutjnl-2021-325989
https://www.medicalnewstoday.com/ar...-play-a-role-in-the-development-of-long-covid

The immune system is disrupted by Covid - e.g., cytokine storm. This disruption appears in the genetic "makeup" of fecal samples.

With long Covid (PACS) defined as at least one persistent symptom 4 weeks after clearance of the SARS-CoV-2 virus.

The article shows an association of long Covid symptoms with a persistent change in species prevalence in fecal samples.

Fecal samples from day of admission and from months after infection, comparing non-long Covid patients feces populations as a control with long Covid patients whose symptoms persist. Example symptoms include: brain fog, fatigue, insomnia, along with a complex rash of other symptoms, since these patients often present with multiple issues. Long Covid can be very debilitating.

Preliminary descriptive case study. Some suggestions for clinical practice include
so-called 'poop pills',
probiotic foods (Ex: kefir, yogurt),
dietary changes.

As an aside: the biggest immune system battle front is in the gut, where most antibodies are "deployed". Obviously these gut antibodies do not hang around for very long. So they are replaced constantly. -- Jon Yewdell MD PhD, Head NIH Cellular Biology Section of the Laboratory of Viral Diseases.
-- which implies some changes have been made in the overall gut immune response, possibly to cope with the hanged microbiota profiles.

 

[Ygggdrasil]

The gut microbiome will change in response to many phenomena. What is the evidence that the changes in the gut micorbiome are a contributing cause to long COVID rather than an effect of long COVID? One could even imagine a situation that the gut microbiome changes to mitigate symptoms of long COVID.

You use the term "permanent" in your summary. I am skeptical that studies would have had long enough time frames to demonstrate that the changes are permanent.

 

[jim mcnamara]

@Ygggdrasil I thought it came from the paper. No matter where it came from, it is likely a big overstatement.
My bad - thanks.

To answer your question - the control group (no long Covid) did not show persistence of changes from baseline. That was interpreted to mean that persistent change (pick a word) only occurred in the test group but not the controls.

 

[Klystron]

After reading both papers, it appears that the study participants remained hospitalized during the study while the control group was not hospitalized. One may assume the controls were (1) not exposed to the listed nosocomial infections and (2) did not receive antibiotic and other medications during the study. Presumably (3) the hospitalized cohort ate hospital food while the controls ate 'normal' non-institutional diets.

All three factors might affect and alter gut biome between the groups irrespective of Covid infection. Controlling factors 1 & 2 in future larger studies could be problematic and ethically challenging but item 3 controlling diet could be doable.