Oral Bacteriotherapy Reduces the Occurrence of Chronic Fatigue in COVID-19 Patients (Santinelli et al, 2022)

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Abstract

Long COVID refers to patients with symptoms as fatigue, “brain fog,” pain, suggesting the chronic involvement of the central nervous system (CNS) in COVID-19. The supplementation with probiotic (OB) would have a positive effect on metabolic homeostasis, negatively impacting the occurrence of symptoms related to the CNS after hospital discharge. On a total of 58 patients hospitalized for COVID-19, 24 (41.4%) received OB during hospitalization (OB+) while 34 (58.6%) taken only the standard treatment (OB–). Serum metabolomic profiling of patients has been performed at both hospital acceptance (T0) and discharge (T1). Six months after discharge, fatigue perceived by participants was assessed by administrating the Fatigue Assessment Scale. 70.7% of participants reported fatigue while 29.3% were negative for such condition. The OB+ group showed a significantly lower proportion of subjects reporting fatigue than the OB– one (p < 0.01). Furthermore, OB+ subjects were characterized by significantly increased concentrations of serum Arginine, Asparagine, Lactate opposite to lower levels of 3-Hydroxyisobutirate than those not treated with probiotics. Our results strongly suggest that in COVID-19, the administration of probiotics during hospitalization may prevent the development of chronic fatigue by impacting key metabolites involved in the utilization of glucose as well as in energy pathways.

The oral supplement used

The commercial oral bacteriotherapy formulation (SLAB51; currently sold under the brand Sivomixx800®, Ormendes, Switzerland) was composed of Streptococcus thermophilus DSM 32245®, Bifidobacterium lactis DSM 32246®, Bifidobacterium lactis DSM 32247®, Lactobacillus acidophilus DSM 32241®, Lactobacillus helveticus DSM 32242®, Lactobacillus paracasei DSM 32243®, Lactobacillus plantarum DSM 32244®, and Lactobacillus brevis DSM 27961®. The formulation was administered in three equal doses per day for a total of 2,400 billion bacteria per day.

Results (6 months)
[...]
A significantly higher proportion of subjects positive for fatigue has been observed in the OB– group compared to those additionally treated with SLAB51 (OB– vs. OB+, 91% (31/34) vs. 41.7% (10/24); p < 0.01). The fatigued patients who had received SLAB51 reported significantly lower FAS scores than those not treated with the probiotic formula [median (IQR), OB+, 24 (22.5–26) vs. OB–, 34 (31.5–38); p = 0.02]. Interestingly, the proportion of subjects presenting extreme fatigue was significantly higher among the OB– group than in the OB+ one [OB– vs. OB+, 29.4 (10/34) vs. 4.2 (1/24); p = 0.047].

Conclusion
[...]
Even considering all the limitations of the present study, some of the evidence can be underlined: (a) subjects infected by the virus, if treated with SLAB51, have a lower incidence of chronic fatigue; (b) the administration of bacteriotherapy induces metabolic changes for a better utilization of glucose and energy pathways. Nevertheless, these findings need to be confirmed by more in-depth analysis and replicated in further studies.

The study
https://www.frontiersin.org/article...70l90f6q5hPnBPm87sOQJ7YMwR6whLpGBCXR9j7FzaPQs
 
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The problem with the gut bacterial dysbiosis idea though is that patients sick for more than 10 yrs apparently seem to have fine gut bacteria (while patients sick for less then 4 years appear to have alot of gut dysbiosis or something like that).

I guess there is some way to explain it though. What do you think of these things?