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Pediatr Neonatol . Alteration of the gut microbiota in children following SARS- CoV-2 infection in 2021 and 2022 pandemics

tetano

Editor, Senior Moderator
Pediatr Neonatol


. 2025 Jul 22:S1875-9572(25)00134-2.
doi: 10.1016/j.pedneo.2025.06.005. Online ahead of print. Alteration of the gut microbiota in children following SARS- CoV-2 infection in 2021 and 2022 pandemics

Geng-Hao Bai[SUP] 1 [/SUP], Hung-Yen Cheng[SUP] 2 [/SUP], Sheng-Chieh Lin[SUP] 3 [/SUP], Yi-Hsiang Hsu[SUP] 4 [/SUP], Yin-Tai Tsai[SUP] 5 [/SUP], Yu-Chen Yang[SUP] 6 [/SUP], Yuan-Hung Wang[SUP] 7 [/SUP], Shih-Yen Chen[SUP] 8 [/SUP]



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Free article Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused significant mortality and morbidity worldwide. Although the role of intestinal microbiota in adults with SARS-CoV-2 infection has been studied, limited research exists on children. This study was performed to investigate the clinical significance and association of intestinal microbiota composition in children with SARS-CoV-2 infection during the 2021 and 2022 pandemic waves in Taiwan.
Methods: Pediatric patients diagnosed with SARS-CoV-2 via real-time reverse transcription polymerase chain reaction were randomly enrolled from Shang-Ho Hospital. The study period covered the two SARS-CoV-2 outbreaks in Taiwan in 2021 and 2022. Medical records were reviewed for clinical manifestations and cycle threshold (Ct) values, and fecal microbiota enrichment analysis was performed using next-generation sequencing and the linear discriminant analysis effect size method.
Results: In total, 21 pediatric patients with confirmed SARS-CoV-2 infection were enrolled-8 from the 2021 pandemic and 13 from the 2022 pandemic. Compared with the 2021 cohort, children infected in 2022 exhibited significantly higher rates of hospitalization (P < 0.001), high fever (>39 °C) (P = 0.0002), and dehydration (P = 0.0001). By contrast, a higher prevalence of a family history of COVID-19 was observed in the 2021 group (P = 0.018). Permutational multivariate analysis of group dispersions (β-dispersion analysis) revealed a trend toward increased β-diversity in the 2021 group (P = 0.06394), along with a higher relative abundance of the genera Peptoniphilus, Fusobacterium, and Morganella.
Conclusion: Our study highlights differences in clinical presentations between the 2021 and 2022 SARS-CoV-2 pandemic waves and suggests an impact of infection on the gut microbiota in children, with marginally higher β-diversity observed in 2021. These findings provide a foundation for future research into the role of intestinal microbiota in pediatric SARS-CoV-2 infection.


 
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