Alterations in Gut Microbiota of Patients With COVID-19 During Time of Hospitalization

[ljimbo423]

@Wolfcub You might find this interesting, given your gut issues from Covid.


Background & Aims

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects gastrointestinal tissues,

little is known about the roles of gut commensal microbes in susceptibility to and severity of infection. We investigated changes in fecal microbiomes of patients with SARS-CoV-2 infection during hospitalization and associations with severity and fecal shedding of virus.

Results

Patients with COVID-19 had significant alterations in fecal microbiomes compared with controls, characterized by enrichment of opportunistic pathogens and depletion of beneficial commensals, at time of hospitalization and at all time points during hospitalization.

Depleted symbionts and gut dysbiosis persisted even after clearance of SARS-CoV-2 (determined from throat swabs) and resolution of respiratory symptoms.

The baseline abundance of Coprobacillus, Clostridium ramosum, and Clostridium hathewayi correlated with COVID-19 severity; there was an inverse correlation between abundance of Faecalibacterium prausnitzii (an anti-inflammatory bacterium) and disease severity.

Over the course of hospitalization, Bacteroides dorei, Bacteroides thetaiotaomicron, Bacteroides massiliensis, and Bacteroides ovatus, which down-regulate expression of angiotensin-converting enzyme 2 (ACE2) in murine gut, correlated inversely with SARS-CoV-2 load in fecal samples from patients.

Conclusions

In a pilot study of 15 patients with COVID-19, we found persistent alterations in the fecal microbiome during the time of hospitalization, compared with controls. Fecal microbiota alterations were associated with fecal levels of SARS-CoV-2 and COVID-19 severity. Strategies to alter the intestinal microbiota might reduce disease severity.

I think Covid 19 causes big, lasting changes in the gut microbiome in some people and this is what's causing "Long Covid".

I think some people that develop Long Covid have a gut microbiome strong enough to re-balance itself and they recover. In others, there gut microbiome can't re-balance itself, so they stay sick.


https://www.sciencedirect.com/science/article/pii/S0016508520347016

 

[Wolfcub]

Thanks for tagging me on this @ljimbo423 It makes very interesting reading.

I started with sudden gut issues (literally overnight) just under a month before the obvious Covid (classic symptoms) infection started. No other symptoms during those few weeks, except the usual crash stuff when I'd done a bit too much.
Oddly, when the very bad respiratory problems and fever etc were happening, my gut was perfectly normal, (and for weeks during recovery also.)

But....my heart was a mess with arrhythmia, and I was peeing red first thing in the morning for 2 -3 days. There seems to be no lasting kidney damage, but my heart beat is still not right, and I don't think it ever will be.

Anyway, though I don't know, it's possible I had already started with Covid when the gut symptoms started.
I felt bad in hindsight, as I'd been in close contact with a couple of people during the time of the upset gut, yet neither of those people caught Covid or any other illness from me.
So it's hard to see what was what.

 

[ljimbo423]

But....my heart was a mess with arrhythmia, and I was peeing red first thing in the morning for 2 -3 days.

That sounds scary, did you ever find out what caused the red urine?

I do think that both Long Covid and CFS involve low grade brain inflammation. Maybe that's what caused your arrhythmia.

 

[ljimbo423]

Anyway, though I don't know, it's possible I had already started with Covid when the gut symptoms started.
I felt bad in hindsight, as I'd been in close contact with a couple of people during the time of the upset gut, yet neither of those people caught Covid or any other illness from me.
So it's hard to see what was what.

I just found this. It looks like it's possible you had Covid before you got sick.

In some cases of COVID-19, gastrointestinal issues may even arise before the respiratory tract is affected.


So, "patients with new-onset of digestive symptoms after a possible contact with COVID-19 or connection with a COVID-19 case should be investigated for COVID-19 illness, even in the absence of the more common upper respiratory symptoms of cough, fever and shortness of breath," Andrawes advised.

https://www.webmd.com/lung/news/20200514/covid-19-can-infect-and-harm-digestive-organs#2

 

[Wolfcub]

It looks like it's possible you had Covid before you got sick.

Yes, in hindsight, it does.
I wish I'd known that at the time. It was weeks before lockdown (early March) and GI symptoms weren't reported then.
Yet why? I don't know, because looking back at some of the earliest case-histories from Wuhan China, GI disturbances were clearly mentioned in a few cases. In most of those cases GI symptoms started hours before, or a day or two, from what I read. I hadn't heard of them starting three + weeks before classic Covid symptoms.

But no....here that wasn't publicised, we were told to look out for dry continual cough (a HUGE understatement!) ....fever, chills.....and then much later -I think during the summer - the loss of sense of smell and taste (which never happened to me.)

I felt bad later about being in close contact with those two people while I had the upset belly, but had no idea it could be Covid-related back then. Luckily, they were fine and didn't develop anything.

 

[Wolfcub]

did you ever find out what caused the red urine?

No. I guessed it was an interference with blood clotting, as I also got petechiae on my torso. I didn't have kidney pain, though an old lower back (lower than kidneys) problem really flared up the first day and ached like heck.
I probably needed some vitamin K at the time.

For interest, in early June which was 2-3 months later I had 3 stool analyses showing no inflammation etc.

 

[ljimbo423]

For interest, in early June which was 2-3 months later I had 3 stool analyses showing no inflammation etc.

I think the inflammation associated with dysbiosis and leaky gut is very often "sub-clinical" or mild. So they probably wouldn't find it through traditional testing.

 

[Wolfcub]

Re: GI damage from blood clots in the intestine....and also the possible opposite effect in some patients, I found this in Medical News Today:

Normally, our blood maintains a delicate balance between its tendency to form clots and its tendency to break them down.

In particular, the body does this by continually adjusting the activity of a protein in the blood called plasminogen, which promotes the breakup of blood clots, or “thrombolysis.”

The body performs this balancing act by changing the levels of two other proteins circulating in the bloodstream, known as tissue plasminogen activator (TPA) and plasminogen activator inhibitor-1.

As their names suggest, the former activates plasminogen and therefore promotes thrombolysis, while the latter has the opposite effect.

 

[ljimbo423]

Re: GI damage from blood clots in the intestine....and also the possible opposite effect in some patients, I found this in Medical News Today:

Interesting.

It shows how 2 people could have opposite effects from the same illness. In this case Covid 19. One could have excessive blood clots the other, excessive bleeding.

 

[Wolfcub]

Yes, apparently it's a small subset of Covid patients who might get the bleeding problem. It seems I got that to some extent. Though there was never any sign of bleeding from the gut itself during infection, and a F.I.T. analysis 2-3 months later was clear for occult blood.