Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Dec;10(4):300-306.
doi: 10.1007/s13668-021-00375-z. Epub 2021 Nov 23.

Impact of COVID-19 on the Intestinal Microbiome

Carla Venegas-Borsellino  1 , Senthilkumar Sankararaman  2 , Keelin Roche  3 , JBracken Burns  3 , Ryan Michael Landis  3
Affiliations
Review

Impact of COVID-19 on the Intestinal Microbiome

Carla Venegas-Borsellino et al. Curr Nutr Rep. 2021 Dec.

Abstract

Purpose of review: This review article aims to explore the GI changes induced by SARS-CoV-2 and how gut microbial homeostasis can influence these changes and affect the lung-gut axis and its relationship with the induction of the cytokine release syndrome in severe COVID-19 patients.

Recent findings: Coronavirus disease 2019 (COVID-19) affects not only the respiratory system but can produce multi-systemic damage. The expression of angiotensin-converting enzyme 2 (ACE-2) receptors in the gastrointestinal (GI) tract, the high prevalence of GI symptoms in severely ill COVID-19 patients, and the abnormalities described in the gut microbiome in these patients have raised concerns about the influence of GI tract as a risk factor or as a potential modulator to reduce the severity of COVID-19. Understanding the mechanisms by which gut dysbiosis may influence viral transmission and disease progression in COVID-19 may help in shaping how accessible therapies, like diet modulation, can potentially help beat the devastating consequences of COVID-19.

Keywords: Brain-gut axis; COVID-19; Cytokine release syndrome; Gastrointestinal manifestations; Microbiome; Probiotics; SARS-CoV-2.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

References

    1. Wei XS, Wang X, Niu YR, Ye LL, Peng WB, Wang ZH, et al. Diarrhea is associated with prolonged symptoms and viral carriage in corona virus disease 2019. Clin Gastroenterol Hepatol. 2020;18(8):1753–9.e2. doi: 10.1016/j.cgh.2020.04.030. - DOI - PMC - PubMed
    1. Lin L, Jiang X, Zhang Z, Huang S, Zhang Z, Fang Z, et al. Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection. Gut. 2020;69(6):997–1001. doi: 10.1136/gutjnl-2020-321013. - DOI - PubMed
    1. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–513. doi: 10.1016/s0140-6736(20)30211-7. - DOI - PMC - PubMed
    1. Marjot T, Webb GJ, Barritt ASt, Moon AM, Stamataki Z, Wong VW et al. COVID-19 and liver disease: mechanistic and clinical perspectives. Nat Rev Gastroenterol Hepatol. 2021:1–17. 10.1038/s41575-021-00426-4. - PMC - PubMed
    1. Sonzogni A, Previtali G, Seghezzi M, Grazia Alessio M, Gianatti A, Licini L, et al. Liver histopathology in severe COVID 19 respiratory failure is suggestive of vascular alterations. Liver Int. 2020;40(9):2110–2116. doi: 10.1111/liv.14601. - DOI - PMC - PubMed
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. • Kim HS. Do an altered gut microbiota and an associated leaky gut affect COVID-19 severity? mBio. 2021;12(1). 10.1128/mBio.03022-20. This article reviews available evidence supporting that an altered gut homeostasis may contribute to the multiorgan manifestations and complications associated to severe illness in patients with severe COVD-19 infection. - PMC - PubMed
    1. Donati Zeppa S, Agostini D, Piccoli G, Stocchi V, Sestili P. Gut microbiota status in COVID-19: an unrecognized player? Front Cell Infect Microbiol. 2020;10:576551. doi: 10.3389/fcimb.2020.576551. - DOI - PMC - PubMed
    1. Wan Y, Li J, Shen L, Zou Y, Hou L, Zhu L, et al. Enteric involvement in hospitalised patients with COVID-19 outside Wuhan. Lancet Gastroenterol Hepatol. 2020;5(6):534–535. doi: 10.1016/s2468-1253(20)30118-7. - DOI - PMC - PubMed
    1. Zhou Q, Verne GN. Intestinal hyperpermeability: a gateway to multi-organ failure? J Clin Invest. 2018;128(11):4764–4766. doi: 10.1172/jci124366. - DOI - PMC - PubMed
    1. Vignesh R, Swathirajan CR, Tun ZH, Rameshkumar MR, Solomon SS, Balakrishnan P. Could perturbation of gut microbiota possibly exacerbate the severity of COVID-19 via cytokine storm? Front Immunol. 2020;11:607734. doi: 10.3389/fimmu.2020.607734. - DOI - PMC - PubMed