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Eur J Pediatr . Intestinal microbiota composition of children with infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and

tetano

Editor, Senior Moderator
Eur J Pediatr


. 2022 May 19.
doi: 10.1007/s00431-022-04494-9. Online ahead of print.
Intestinal microbiota composition of children with infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and multisystem inflammatory syndrome (MIS-C)


Cansu Suskun[SUP] 1 [/SUP], Omer Kilic[SUP] 2 [/SUP], Dilek Yilmaz Ciftdogan[SUP] 3 [/SUP], Sirin Guven[SUP] 4 [/SUP], Adem Karbuz[SUP] 5 [/SUP], Aslinur Ozkaya Parlakay[SUP] 6 [/SUP], Yalcın Kara[SUP] 2 [/SUP], Ebru Kacmaz[SUP] 7 [/SUP], Aslihan Sahin[SUP] 3 [/SUP], Aysun Boga[SUP] 4 [/SUP], Didem Kizmaz Isancli[SUP] 5 [/SUP], Belgin Gulhan[SUP] 8 [/SUP], Saliha Kanik Yuksek[SUP] 8 [/SUP], Eylem Kiral[SUP] 7 [/SUP], Gurkan Bozan[SUP] 7 [/SUP], Mehmet Ozgür Arslanoglu[SUP] 7 [/SUP], Mahmut Can Kizil[SUP] 2 [/SUP], Meltem Dinleyici[SUP] 9 [/SUP], Tercan Us[SUP] 10 [/SUP], Ahmet Varis[SUP] 11 [/SUP], Mucahit Kaya[SUP] 11 [/SUP], Yvan Vandenplas[SUP] 12 [/SUP], Ener Cagri Dinleyici[SUP] 13 [/SUP]



Affiliations

Abstract

Microbiota composition may play a role in the development, prognosis, or post-infection of COVID-19. There are studies evaluating the microbiota composition at the time of diagnosis and during the course of COVID-19, especially in adults, while studies in children are limited and no study available in children with multisystem inflammatory syndrome in children (MIS-C). This study was planned to compare intestinal microbiota composition in children diagnosed with MIS-C and acute COVID-19 infection with healthy children. In this prospective multicenter study, 25 children diagnosed with MIS-C, 20 with COVID-19 infection, and 19 healthy children were included. Intestinal microbiota composition was evaluated by 16 s rRNA gene sequencing. We observed changes of diversity, richness, and composition of intestinal microbiota in MIS-C cases compared to COVID-19 cases and in the healthy controls. The Shannon index was higher in the MIS-C group than the healthy controls (p < 0.01). At phylum level, in the MIS-C group, a significantly higher relative abundance of Bacteroidetes and lower abundance of Firmicutes was found compared to the control group. Intestinal microbiota composition changed in MIS-C cases compared to COVID-19 and healthy controls, and Faecalibacterium prausnitzii decreased; Bacteroides uniformis, Bacteroides plebeius, Clostridium ramosum, Eubacterium dolichum, Eggerthella lenta, Bacillus thermoamylovorans, Prevotella tannerae, and Bacteroides coprophilus were dominant in children with MIS-C. At species level, we observed decreased Faecalibacterium prausnitzii, and increased Eubacterium dolichum, Eggerthella lenta, and Bacillus thermoamylovorans in children with MIS-C and increased Bifidobacterium adolescentis and Dorea formicigenerasus in the COVID-19 group. Our study is the first to evaluate the microbiota composition in MIS-C cases. There is a substantial change in the composition of the gut microbiota: (1) reduction of F. prausnitzii in children with MIS-C and COVID-19; (2) an increase of Eggerthella lenta which is related with autoimmunity; and (3) the predominance of E. dolichum is associated with metabolic dysfunctions and obesity in children with MIS-C.
Conclusions: Alterations of the intestinal microbiota might be part of pathogenesis of predisposing factor for MIS-C. It would be beneficial to conduct more extensive studies on the cause-effect relationship of these changes in microbiota composition and their effects on long-term prognosis.
What is known: • Microbiota composition may play a role in the development, prognosis, or post-infection of COVID-19. • However, the number of studies on children is limited, and no study on multisystem inflammatory syndrome in children is currently available (MIS-C).
What is new: • In individuals with MIS-C, the composition of the gut microbiota changed dramatically. • Decreased Faecalibacterium prausnitzii have been observed, increased Eggerthella lenta, which was previously linked to autoimmunity, and predominance of Eubacterium dolichum which was linked to metabolic dysfunction and obesity.

Keywords: COVID-19; Children; MIS-C; Microbiome; Microbiota; Multisystem inflammatory syndrome in children.
 
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