World Journal of Medical Microbiology
Opinion | Open Access | 10.31586/wjmm.2022.372

Role of Probiotics in COVID-19 Management?

Samar Osama Ahmed Hassan1, Manal Sabry Mohamed2, Mina Mikhail Nessim2, Mohamed Nabil Badawy Al Ashram2 and Mohamed Farouk Allam1,3,*
1
Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2
Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
3
Department of Preventive Medicine and Public Health, University of Cordoba School of Medicine, Cordoba 14004, Spain

Abstract

Probiotics as an intestinal microbe regulator, not only improve the ability of the gastrointestinal microbiota to modulate immune activity, but also strengthen the body's immune system, inhibit allergic reactions and has a significant role especially in the anti-viral immunomodulation. Therefore, in patients with COVID-19, the intestinal micro-eco-regulator, represented by probiotics, may be a therapeutic choice. However, there is still a lack of evidence-based studies to support probiotic treatment of patients with COVID-19. New cohort studies and randomized controlled clinical trials to assess the effectiveness of probiotics in the management of COVID-19 are strongly and urgently needed.

Research Opinion

At the end of 2019, a novel coronavirus was identified as the causative of a cluster of pneumonia cases in Wuhan (China), resulting in an epidemic throughout China, followed by a global pandemic. In February 2020, the World Health Organization (WHO) announced the disease COVID-19, which stands for coronavirus disease 2019 (WHO, 2020).

The common symptoms of COVID-19 infection include fever, dry cough, shortness of breath, and breathing difficulties less common symptoms include anosmia, sore throat, runny nose, vomiting and diarrhoea (CDC, 2022).

Early reports from Wuhan showed that 2-10% of patients with COVID-19 infection had gastrointestinal symptoms such as diarrhoea, vomiting and abdominal pain. About 10% of the patients presented with diarrhoea and nausea 1-2 days before the development of fever and respiratory symptoms (Yeo et al., 2020). Moreover, another study involving 1141 COVID-19 patients found that 183 of the 1141 patients (nearly 16%) presented with gastrointestinal symptoms only (Su et al., 2020).

COVID-19 disease are characterised by gut microbiome dysbiosis, immune dysregulation, hyper-inflammation, and cytokine storm (Angurana and Bansal, 2020).

Gut microbiota configuration was associated with COVID-19 disease severity, and altered gut microbiota persisted even after clearance of the virus, suggesting that the virus might inflict prolonged harm to human microbiome homoeostasis (Effenberger et al., 2020).

Probiotics are live microorganisms that when administered in adequate amounts confer a health benefit on the host (Hill et al., 2014).

Probiotics as an intestinal microbe regulator, not only improve the ability of the gastrointestinal microbiota to modulate immune activity, but also strengthen the body's immune system, inhibit allergic reactions and has a significant role especially in the anti-viral immunomodulation (Zhang et al., 2020).

Therefore, in patients with COVID-19, the intestinal micro-eco-regulator, represented by probiotics, may be a therapeutic choice. However, there is still a lack of evidence-based studies to support probiotic treatment of patients with COVID-19.

New cohort studies and randomized controlled clinical trials to assess the effectiveness of probiotics in the management of COVID-19 are strongly and urgently needed.

References

  1. Angurana SK, Bansal A. Probiotics and Coronavirus disease 2019: think about the link. Br J Nutr. 2021 Nov 28;126(10):1564-1570. doi: 10.1017/S000711452000361X.[CrossRef] [PubMed]
  2. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) 2021 Case Definition. Available at: https://ndc.services.cdc.gov/case-definitions/coronavirus-disease-2019-2021/ (last access May 5, 2022).
  3. Effenberger M, Grabherr F, Mayr L, Schwaerzler J, Nairz M, Seifert M, Hilbe R, Seiwald S, Scholl-Buergi S, Fritsche G, Bellmann-Weiler R, Weiss G, Müller T, Adolph TE, Tilg H. Faecal calprotectin indicates intestinal inflammation in COVID-19. Gut 2020;69(8):1543-1544. doi: 10.1136/gutjnl-2020-321388.[CrossRef] [PubMed]
  4. Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, Morelli L, Canani RB, Flint HJ, Salminen S, Calder PC, Sanders ME. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol 2014;11(8):506-514. doi: 10.1038/nrgastro.2014.66.[CrossRef] [PubMed]
  5. Su S, Shen J, Zhu L, Qiu Y, He JS, Tan JY, Iacucci M, Ng SC, Ghosh S, Mao R, Liang J. Involvement of digestive system in COVID-19: manifestations, pathology, management and challenges. Therap Adv Gastroenterol. 2020;13:1756284820934626. doi: 10.1177/1756284820934626.[CrossRef] [PubMed]
  6. World Health Organization. Clinical management of COVID-19: interim guidance, 27 May 2020. Available at: https://apps.who.int/iris/bitstream/handle/10665/332196/WHO-2019-nCoV-clinical-2020.5-eng.pdf?sequence=1&isAllowed=y (last access May 5, 2022).
  7. World Health Organization. Rolling updates on coronavirus disease (COVID-19). Updated 31 July 2020. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen (last access May 5, 2022).
  8. Yeo C, Kaushal S, Yeo D. Enteric involvement of coronaviruses: is faecal-oral transmission of SARS-CoV-2 possible? Lancet Gastroenterol Hepatol 2020;5(4):335-337. doi: 10.1016/S2468-1253(20)30048-0.[CrossRef]
  9. Zhang H, Yeh C, Jin Z, Ding L, Liu BY, Zhang L, Dannelly HK. Prospective study of probiotic supplementation results in immune stimulation and improvement of upper respiratory infection rate. Synth Syst Biotechnol 2018;3(2):113-120. doi: 10.1016/j.synbio.2018.03.001.[CrossRef] [PubMed]

Copyright

© 2024 by authors and Scientific Publications. This is an open access article and the related PDF distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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How to Cite

Ahmed Hassan, S. O., Mohamed, M. S., Nessim, M. M., Ashram, M. N. B. A., & Allam, M. F. (2022). Role of Probiotics in COVID-19 Management?. World Journal of Medical Microbiology, 1(1), 13–14. Retrieved from https://www.scipublications.com/journal/index.php/wjmm/article/view/372
  1. Angurana SK, Bansal A. Probiotics and Coronavirus disease 2019: think about the link. Br J Nutr. 2021 Nov 28;126(10):1564-1570. doi: 10.1017/S000711452000361X.[CrossRef] [PubMed]
  2. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) 2021 Case Definition. Available at: https://ndc.services.cdc.gov/case-definitions/coronavirus-disease-2019-2021/ (last access May 5, 2022).
  3. Effenberger M, Grabherr F, Mayr L, Schwaerzler J, Nairz M, Seifert M, Hilbe R, Seiwald S, Scholl-Buergi S, Fritsche G, Bellmann-Weiler R, Weiss G, Müller T, Adolph TE, Tilg H. Faecal calprotectin indicates intestinal inflammation in COVID-19. Gut 2020;69(8):1543-1544. doi: 10.1136/gutjnl-2020-321388.[CrossRef] [PubMed]
  4. Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, Morelli L, Canani RB, Flint HJ, Salminen S, Calder PC, Sanders ME. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol 2014;11(8):506-514. doi: 10.1038/nrgastro.2014.66.[CrossRef] [PubMed]
  5. Su S, Shen J, Zhu L, Qiu Y, He JS, Tan JY, Iacucci M, Ng SC, Ghosh S, Mao R, Liang J. Involvement of digestive system in COVID-19: manifestations, pathology, management and challenges. Therap Adv Gastroenterol. 2020;13:1756284820934626. doi: 10.1177/1756284820934626.[CrossRef] [PubMed]
  6. World Health Organization. Clinical management of COVID-19: interim guidance, 27 May 2020. Available at: https://apps.who.int/iris/bitstream/handle/10665/332196/WHO-2019-nCoV-clinical-2020.5-eng.pdf?sequence=1&isAllowed=y (last access May 5, 2022).
  7. World Health Organization. Rolling updates on coronavirus disease (COVID-19). Updated 31 July 2020. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen (last access May 5, 2022).
  8. Yeo C, Kaushal S, Yeo D. Enteric involvement of coronaviruses: is faecal-oral transmission of SARS-CoV-2 possible? Lancet Gastroenterol Hepatol 2020;5(4):335-337. doi: 10.1016/S2468-1253(20)30048-0.[CrossRef]
  9. Zhang H, Yeh C, Jin Z, Ding L, Liu BY, Zhang L, Dannelly HK. Prospective study of probiotic supplementation results in immune stimulation and improvement of upper respiratory infection rate. Synth Syst Biotechnol 2018;3(2):113-120. doi: 10.1016/j.synbio.2018.03.001.[CrossRef] [PubMed]

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