Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary Therapeutic Strategy to Avoid the Progression of COVID-19
d'Ettorre et al.,
Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary..,
Frontiers in Medicine, doi:10.3389/fmed.2020.00389
Retrospective 70 hospitalized patients in Italy, 28 treated with probiotic Sivomixx, showing lower risk of respiratory failure and faster recovery with treatment.
The immune effects of probiotics are strain-specific.
risk of death, 87.0% lower, RR 0.13, p = 0.14, treatment 0 of 28 (0.0%), control 4 of 42 (9.5%), NNT 10, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
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risk of mechanical ventilation, 76.9% lower, RR 0.23, p = 0.51, treatment 0 of 28 (0.0%), control 2 of 42 (4.8%), NNT 21, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
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respiratory failure, 88.4% lower, OR 0.12, p = 0.01, treatment 28, control 42, inverted to make OR<1 favor treatment, RR approximated with OR.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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d'Ettorre et al., 7 Jul 2020, retrospective, Italy, peer-reviewed, 17 authors.
Abstract: ORIGINAL RESEARCH
published: 07 July 2020
doi: 10.3389/fmed.2020.00389
Challenges in the Management of
SARS-CoV2 Infection: The Role of
Oral Bacteriotherapy as
Complementary Therapeutic
Strategy to Avoid the Progression of
COVID-19
Edited by:
Alessandro Russo,
University of Pisa, Italy
Reviewed by:
Antonio Vena,
University of Genoa, Italy
Alice Picciarella,
Policlinico Casilino, Italy
*Correspondence:
Giancarlo Ceccarelli
giancarlo.ceccarelli@uniroma1.it
† These
authors share first authorship
Specialty section:
This article was submitted to
Infectious Diseases, Surveillance,
Prevention and Treatment,
a section of the journal
Frontiers in Medicine
Received: 09 May 2020
Accepted: 22 June 2020
Published: 07 July 2020
Citation:
d’Ettorre G, Ceccarelli G,
Marazzato M, Campagna G,
Pinacchio C, Alessandri F, Ruberto F,
Rossi G, Celani L, Scagnolari C,
Mastropietro C, Trinchieri V,
Recchia GE, Mauro V, Antonelli G,
Pugliese F and Mastroianni CM (2020)
Challenges in the Management of
SARS-CoV2 Infection: The Role of
Oral Bacteriotherapy as
Complementary Therapeutic Strategy
to Avoid the Progression of
COVID-19. Front. Med. 7:389.
doi: 10.3389/fmed.2020.00389
Frontiers in Medicine | www.frontiersin.org
Gabriella d’Ettorre 1† , Giancarlo Ceccarelli 1*† , Massimiliano Marazzato 1 ,
Giuseppe Campagna 2 , Claudia Pinacchio 1 , Francesco Alessandri 3 , Franco Ruberto 3 ,
Giacomo Rossi 4 , Luigi Celani 1 , Carolina Scagnolari 5 , Cristina Mastropietro 1 ,
Vito Trinchieri 1 , Gregorio Egidio Recchia 1 , Vera Mauro 1 , Guido Antonelli 5 ,
Francesco Pugliese 3 and Claudio Maria Mastroianni 1
1
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy, 2 Department of Clinical and
Molecular Medicine, Sapienza University of Rome, Rome, Italy, 3 Department of Anesthesia and Intensive Care Medicine,
Sapienza University of Rome, Rome, Italy, 4 School of Biosciences, Veterinary Medicine University of Camerino, Camerino,
Italy, 5 Laboratory of Virology, Department of Molecular Medicine, Affiliated to Istituto Pasteur Italia - Cenci Bolognetti
Foundation, Sapienza University, Rome, Italy
Background: Gastrointestinal disorders are frequent in COVID-19 and SARS-CoV-2
has been hypothesized to impact on host microbial flora and gut inflammation, infecting
intestinal epithelial cells. Since there are currently no coded therapies or guidelines for
treatment of COVID-19, this study aimed to evaluate the possible role of a specific
oral bacteriotherapy as complementary therapeutic strategy to avoid the progression
of COVID-19.
Methods: We provide a report of 70 patients positive for COVID-19, hospitalized
between March 9th and April 4th, 2020. All the patients had fever, required non-invasive
oxygen therapy and presented a CT lung involvement on imaging more than 50%.
Forty-two patients received hydroxychloroquine, antibiotics, and tocilizumab, alone or
in combination. A second group of 28 subjects received the same therapy added with
oral bacteriotherapy, using a multistrain formulation.
Results: The two cohorts of patients were comparable for age, sex, laboratory
values, concomitant pathologies, and the modality of oxygen support. Within 72 h,
nearly all patients treated with bacteriotherapy showed remission of diarrhea and
other symptoms as compared to less than half of the not supplemented group.
The estimated risk of developing respiratory failure was eight-fold lower in patients
receiving oral bacteriotherapy. Both the..
Late treatment
is less effective
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