Is a healthy microbiome responsible for lower mortality in COVID-19?
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OPINION
Is a healthy microbiome responsible for lower mortality in COVID-19? Lubomír Janda 1
&
Matúš Mihalčin 2,3
&
Michaela Šťastná 1
Received: 28 June 2020 / Accepted: 30 September 2020 # Institute of Molecular Biology, Slovak Academy of Sciences 2020
Abstract The novel severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) is the cause of an ongoing pandemic with significant case fatality ratio (CFR) worldwide. Although SARS-CoV-2 primarily causes respiratory infection by binding to ACE2 receptors present on alveolar epithelial cells, studies have been published linking the disease to the small intestine enterocytes and its microbiome. Dysbiosis of microbiome, mainly intestinal and lung, can affect the course of the disease. Environmental factors, such as reduced intake of commensal bacteria from the environment or their products in the diet, play an important role in microbiome formation, which can significantly affect the immune response. In elderly, obese or chronically ill people, the microbiota is often damaged. Therefore, we speculate that a good microbiome may be one of the factors responsible for lower CFR from the coronavirus disease 2019 (COVID-19). An approach using tailored nutrition and supplements known to improve the intestinal microbiota and its immune function might help minimize the impact of the disease at least on people at higher risk from coronavirus. Abbreviations ARDS COPD COVID-19 CFR LAB LPS SARS-CoV-2 SCFAs
Acute respiratory distress syndrome Chronic obstructive pulmonary disease The coronavirus disease 2019 Case fatality ratio Lactic acid bacteria Lipopolysaccharides Severe acute respiratory syndrome Coronavirus 2 Short-chain fatty acids
Introduction to coronavirus biology The new SARS-CoV-2 virus (severe acute respiratory syndrome C orona virus 2) belon gs to th e subfamily Coronavirinae (order Nidovirales, family Coronaviridae), * Lubomír Janda [email protected] 1
Clinical Immunology and Immunology of Infectious Diseases, Veterinary Research Institute, Brno, Hudcova 70, 621 00 Brno, Czech Republic
2
Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
3
Department of Infectious Diseases, University Hospital Brno, Jihlavská 20, 625 00 Brno, Czech Republic
which includes a diverse group of similar viruses of medical and veterinary importance. Coronaviruses (CoVs) are enveloped, positive-sense RNA viruses that contain the largest known RNA genomes with a length of up to 32 kb. This subfamily is divided into four genera: alpha-, beta-, gammaand delta-coronavirus (α-, β-, γ- and δ-CoV). The first two families include species capable of causing disease in humans. The α-coronavirus class includes two viruses, HCoV-NL63 and HCoV-229E, while the β-coronavirus class includes two other viruses, HCoV-OC43 and HCoV-HKU1. These four common HCoV viruses generally cause mild upper respiratory tract disease and contribute to 15–30% of colds in adults. Severe and life-threatening lower respiratory tract infections such as pneumonia and / or bronchitis cause
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