tetano
Editor, Senior Moderator
J Intern Med
. 2022 Feb 25.
doi: 10.1111/joim.13458. Online ahead of print.
Respiratory dysfunction three months after severe COVID-19 is associated with gut microbiota alterations
Beate Vestad[SUP] 1 2 [/SUP], Thor Ueland[SUP] 1 3 [/SUP], Tøri Vigeland Lerum[SUP] 3 4 [/SUP], Tuva Børresdatter Dahl[SUP] 1 5 [/SUP], Kristian Holm[SUP] 1 2 3 [/SUP], Andreas Barratt-Due[SUP] 5 6 [/SUP], Trine Kåsine[SUP] 3 5 [/SUP], Anne Ma Dyrhol-Riise[SUP] 3 7 [/SUP], Birgitte Stiksrud[SUP] 3 7 [/SUP], Kristian Tonby[SUP] 3 7 [/SUP], Hedda Hoel[SUP] 1 3 8 [/SUP], Inge Christoffer Olsen[SUP] 9 [/SUP], Katerina Nezvalova Henriksen[SUP] 10 11 [/SUP], Anders Tveita[SUP] 12 [/SUP], Ravinea Manotheepan[SUP] 13 [/SUP], Mette Haugli[SUP] 14 [/SUP], Ragnhild Eiken[SUP] 15 [/SUP], Åse Berg[SUP] 16 [/SUP], Bente Halvorsen[SUP] 1 3 [/SUP], Tove Lekva[SUP] 1 [/SUP], Trine Ranheim[SUP] 1 [/SUP], Annika Elisabeth Michelsen[SUP] 1 3 [/SUP], Anders Benjamin Kildal[SUP] 17 [/SUP], Asgeir Johannessen[SUP] 3 18 [/SUP], Lars Thoresen[SUP] 19 [/SUP], Hilde Skudal[SUP] 20 [/SUP], Bård Reiakvam Kittang[SUP] 21 [/SUP], Roy Bjørkholt Olsen[SUP] 22 [/SUP], Carl Magnus Ystrøm[SUP] 23 [/SUP], Nina Vibeche Skei[SUP] 24 [/SUP], Raisa Hannula[SUP] 25 [/SUP], Saad Aballi[SUP] 26 [/SUP], Reidar Kvåle[SUP] 27 [/SUP], Ole Henning Skjønsberg[SUP] 3 4 [/SUP], Pål Aukrust[SUP] 1 3 28 [/SUP], Johannes Roksund Hov[SUP] 1 2 3 29 [/SUP], Marius Trøseid[SUP] 1 3 28 [/SUP]
Affiliations
Abstract
Background: Although coronavirus disease 2019 (COVID-19) is primarily a respiratory infection, mounting evidence suggests that the gastrointestinal (GI) tract is involved in the disease, with gut barrier dysfunction and gut microbiota alterations being related to disease severity. Whether these alterations persist and are related to long-term respiratory dysfunction remains unknown.
Methods: Plasma was collected during hospital admission and after three months from the NOR-Solidarity trial (n = 181) and analysed for markers of gut barrier dysfunction and inflammation. At the three-month follow-up, pulmonary function was assessed by measuring the diffusing capacity of the lungs for carbon monoxide (DL[SUB]CO[/SUB] ). Rectal swabs for gut microbiota analyses were collected (n = 97) and analysed by sequencing the 16S rRNA gene.
Results: Gut microbiota diversity was reduced in COVID-19 patients with respiratory dysfunction, defined as DL[SUB]CO[/SUB] below the lower limit of normal three months after hospitalisation. These patients also had an altered global gut microbiota composition, with reduced relative abundance of 20 bacterial taxa and increased abundance of five taxa, including Veillonella, potentially linked to fibrosis. During hospitalisation, increased plasma levels of lipopolysaccharide-binding protein (LBP) were strongly associated with respiratory failure, defined as pO[SUB]2[/SUB] /fiO[SUB]2[/SUB] -(P/F ratio) < 26.6 kPa. LBP levels remained elevated during and after hospitalisation and were associated with low-grade inflammation and respiratory dysfunction after three months.
Conclusion: Respiratory dysfunction after COVID-19 is associated with altered gut microbiota and persistently elevated LBP levels. Our results should be regarded as hypothesis-generating, pointing to a potential gut-lung axis that should be further investigated in relation to long-term pulmonary dysfunction and long COVID. This article is protected by copyright. All rights reserved.
Keywords: SARS-CoV-2; microbiome; pulmonary function.
. 2022 Feb 25.
doi: 10.1111/joim.13458. Online ahead of print.
Respiratory dysfunction three months after severe COVID-19 is associated with gut microbiota alterations
Beate Vestad[SUP] 1 2 [/SUP], Thor Ueland[SUP] 1 3 [/SUP], Tøri Vigeland Lerum[SUP] 3 4 [/SUP], Tuva Børresdatter Dahl[SUP] 1 5 [/SUP], Kristian Holm[SUP] 1 2 3 [/SUP], Andreas Barratt-Due[SUP] 5 6 [/SUP], Trine Kåsine[SUP] 3 5 [/SUP], Anne Ma Dyrhol-Riise[SUP] 3 7 [/SUP], Birgitte Stiksrud[SUP] 3 7 [/SUP], Kristian Tonby[SUP] 3 7 [/SUP], Hedda Hoel[SUP] 1 3 8 [/SUP], Inge Christoffer Olsen[SUP] 9 [/SUP], Katerina Nezvalova Henriksen[SUP] 10 11 [/SUP], Anders Tveita[SUP] 12 [/SUP], Ravinea Manotheepan[SUP] 13 [/SUP], Mette Haugli[SUP] 14 [/SUP], Ragnhild Eiken[SUP] 15 [/SUP], Åse Berg[SUP] 16 [/SUP], Bente Halvorsen[SUP] 1 3 [/SUP], Tove Lekva[SUP] 1 [/SUP], Trine Ranheim[SUP] 1 [/SUP], Annika Elisabeth Michelsen[SUP] 1 3 [/SUP], Anders Benjamin Kildal[SUP] 17 [/SUP], Asgeir Johannessen[SUP] 3 18 [/SUP], Lars Thoresen[SUP] 19 [/SUP], Hilde Skudal[SUP] 20 [/SUP], Bård Reiakvam Kittang[SUP] 21 [/SUP], Roy Bjørkholt Olsen[SUP] 22 [/SUP], Carl Magnus Ystrøm[SUP] 23 [/SUP], Nina Vibeche Skei[SUP] 24 [/SUP], Raisa Hannula[SUP] 25 [/SUP], Saad Aballi[SUP] 26 [/SUP], Reidar Kvåle[SUP] 27 [/SUP], Ole Henning Skjønsberg[SUP] 3 4 [/SUP], Pål Aukrust[SUP] 1 3 28 [/SUP], Johannes Roksund Hov[SUP] 1 2 3 29 [/SUP], Marius Trøseid[SUP] 1 3 28 [/SUP]
Affiliations
- PMID: 35212063
- DOI: 10.1111/joim.13458
Abstract
Background: Although coronavirus disease 2019 (COVID-19) is primarily a respiratory infection, mounting evidence suggests that the gastrointestinal (GI) tract is involved in the disease, with gut barrier dysfunction and gut microbiota alterations being related to disease severity. Whether these alterations persist and are related to long-term respiratory dysfunction remains unknown.
Methods: Plasma was collected during hospital admission and after three months from the NOR-Solidarity trial (n = 181) and analysed for markers of gut barrier dysfunction and inflammation. At the three-month follow-up, pulmonary function was assessed by measuring the diffusing capacity of the lungs for carbon monoxide (DL[SUB]CO[/SUB] ). Rectal swabs for gut microbiota analyses were collected (n = 97) and analysed by sequencing the 16S rRNA gene.
Results: Gut microbiota diversity was reduced in COVID-19 patients with respiratory dysfunction, defined as DL[SUB]CO[/SUB] below the lower limit of normal three months after hospitalisation. These patients also had an altered global gut microbiota composition, with reduced relative abundance of 20 bacterial taxa and increased abundance of five taxa, including Veillonella, potentially linked to fibrosis. During hospitalisation, increased plasma levels of lipopolysaccharide-binding protein (LBP) were strongly associated with respiratory failure, defined as pO[SUB]2[/SUB] /fiO[SUB]2[/SUB] -(P/F ratio) < 26.6 kPa. LBP levels remained elevated during and after hospitalisation and were associated with low-grade inflammation and respiratory dysfunction after three months.
Conclusion: Respiratory dysfunction after COVID-19 is associated with altered gut microbiota and persistently elevated LBP levels. Our results should be regarded as hypothesis-generating, pointing to a potential gut-lung axis that should be further investigated in relation to long-term pulmonary dysfunction and long COVID. This article is protected by copyright. All rights reserved.
Keywords: SARS-CoV-2; microbiome; pulmonary function.