The role of nutritional support with probiotics in outpatients with symptomatic acute respiratory tract infections: a multicenter, randomized, double-blind, placebo-controlled dietary study

DOI record: { "DOI": "10.1186/s40795-023-00816-8", "ISSN": [ "2055-0928" ], "URL": "http://dx.doi.org/10.1186/s40795-023-00816-8", "abstract": "<jats:title>Abstract</jats:title><jats:sec>\n <jats:title>Background</jats:title>\n <jats:p>A number of laboratory data and clinical studies have shown that probiotic bacteria may be beneficial in respiratory viral diseases. We investigated the role of probiotics in coronavirus disease-19 (COVID -19), post-disease symptoms, and humoral immune responses to viral antigens.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>This was a randomized, double-blind, placebo-controlled, prospective, multicenter study. We included symptomatic patients aged 18–65 years without risk of severe disease, and positive antigen/PCR test for SARS-CoV-2. Patients received (<jats:italic>Bifidobacterium (B.) lactis</jats:italic> BI040, <jats:italic>B. longum</jats:italic> BL020, <jats:italic>Lactobacillus (L) rhamnosus</jats:italic> LR110, <jats:italic>L. casei</jats:italic> LC130, <jats:italic>L. acidophilus</jats:italic> LA120, 5 billion CFU total) or placebo 1 capsule a day for 28 days and recorded symptoms. Three months later patients completed Post-COVID-19 Questionnaire (PCQ-19). On days 0–5 and 28–35, blood was sampled for IgG to nucleocapsid protein (NCP) and receptor binding domain (RBD)/spike 1 (S1) protein. The primary outcome measure was a patient global symptom score on day 10 of observation. The difference between groups was assessed using the Mann–Whitney <jats:italic>U</jats:italic> test.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>Seventy-three patients were assessed for clinical endpoints and 44 patients were evaluated for antibody production. At day 10, the median global symptom score (interquartile range) was lower in the probiotic group (0.0 (0.0–2.0) vs. 2.0 (1.0–5.0), <jats:italic>P</jats:italic> &lt; 0.05). The probiotic group had a shorter duration of fatigue and anxiety after COVID -19 (<jats:italic>P</jats:italic> &lt; 0.05) and a greater change in IgG concentration on RBD/S1 (225.9 vs. 105.6 binding antibody units/mL, <jats:italic>P</jats:italic> &lt; 0.05).</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Conclusions</jats:title>\n <jats:p>Use of probiotics alleviates acute and post-disease symptoms, and improves humoral immune response to viral antigens.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Trial registration</jats:title>\n <jats:p>Registered at clinicaltrials.gov as NCT04907877, June 1, 2021.</jats:p>\n </jats:sec>", "alternative-id": [ "816" ], "article-number": "4", "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "10 July 2023" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "22 December 2023" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "4 January 2024" }, { "group": { "label": "Declarations", "name": "EthicsHeading" }, "name": "Ethics", "order": 1 }, { "group": { "label": "Ethics approval and consent to participate", "name": "EthicsHeading" }, "name": "Ethics", "order": 2, "value": "Approvals were obtained from ethical committees at all study sites (Lviv Oblast Center for Disease Control and Prevention Ministry of Health of Ukraine, protocol #2 of 20 Apr 2021; Lviv Municipal Non-Profit Enterprise Third City Clinical Hospital, protocol #1 of 03 Jun 2021; Hemo Medica Clinic, protocol #2 of 09 Jun 2021; Vinnytsia Municipal Non-Profit Enterprise Center of Primary Health Care №2, protocol #24 of 18 Jan 2022; Chernivtsi Municipal Non-Profit Enterprise City Polyclinic №1, protocol #2 of 24 Jan 2022.The study was conducted in accordance with the principles of the Declaration of Helsinki and the privacy rights of patients were respected in compliance with Good Clinical Practices throughout the study. Before enrollment in the study, eligible participants had protocol-specific health insurance and were familiarized with the study procedures. A signed informed consent was obtained from all patients. This study was registered at ClinicalTrials.gov on July 01, 2021 before the first patient signed the informed consent form (identifier: NCT04907877)." }, { "group": { "label": "Consent for publication", "name": "EthicsHeading" }, "name": "Ethics", "order": 3, "value": "Not applicable." }, { "group": { "label": "Competing interests", "name": "EthicsHeading" }, "name": "Ethics", "order": 4, "value": "POK, IHP, LPS, ZРH, OSL, NRH received investigator fees; SVG received study management fee from Nordic Biotic Sp. z o.o. (Warsaw, Poland). NOI, OIM, ZLS reported no competing interests." } ], "author": [ { "affiliation": [], "family": "Kolesnyk", "given": "Pavlo O.", "sequence": "first" }, { "affiliation": [], "family": "Paliy", "given": "Iryna H.", "sequence": "additional" }, { "affiliation": [], "family": "Sydorchuk", "given": "Larysa P.", "sequence": "additional" }, { "affiliation": [], "family": "Hoda", "given": "Zoriana P.", "sequence": "additional" }, { "affiliation": [], "family": "Ivanchenko", "given": "Nataliya O.", "sequence": "additional" }, { "affiliation": [], "family": "Lych", "given": "Oksana S.", "sequence": "additional" }, { "affiliation": [], "family": "Huley", "given": "Natalia R.", "sequence": "additional" }, { "affiliation": [], "family": "Matsyura", "given": "Oksana I.", "sequence": "additional" }, { "affiliation": [], "family": "Slyuzar", "given": "Zoryana L.", "sequence": "additional" }, { "affiliation": [], "family": "Gerasymov", "given": "Sergiy V.", "sequence": "additional" } ], "container-title": "BMC Nutrition", "container-title-short": "BMC Nutr", "content-domain": { "crossmark-restriction": false, "domain": [ "link.springer.com" ] }, "created": { "date-parts": [ [ 2024, 1, 4 ] ], "date-time": "2024-01-04T15:05:48Z", "timestamp": 1704380748000 }, "deposited": { "date-parts": [ [ 2024, 1, 4 ] ], "date-time": "2024-01-04T15:10:19Z", "timestamp": 1704381019000 }, "funder": [ { "award": [ "# DT0003A-COV", "# DT0003A-COV", "# DT0003A-COV", "# DT0003A-COV", "# DT0003A-COV", "# DT0003A-COV", "# DT0003A-COV" ], "name": "Nordic Biotic Sp. z o.o." } ], "indexed": { "date-parts": [ [ 2024, 1, 5 ] ], "date-time": "2024-01-05T00:15:48Z", "timestamp": 1704413748419 }, "is-referenced-by-count": 0, "issue": "1", "issued": { "date-parts": [ [ 2024, 1, 4 ] ] }, "journal-issue": { "issue": "1", "published-online": { "date-parts": [ [ 2024, 12 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2024, 1, 4 ] ], "date-time": "2024-01-04T00:00:00Z", "timestamp": 1704326400000 } }, { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2024, 1, 4 ] ], "date-time": "2024-01-04T00:00:00Z", "timestamp": 1704326400000 } } ], "link": [ { "URL": "https://link.springer.com/content/pdf/10.1186/s40795-023-00816-8.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/article/10.1186/s40795-023-00816-8/fulltext.html", "content-type": "text/html", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/content/pdf/10.1186/s40795-023-00816-8.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "297", "original-title": [], "prefix": "10.1186", "published": { "date-parts": [ [ 2024, 1, 4 ] ] }, "published-online": { "date-parts": [ [ 2024, 1, 4 ] ] }, "publisher": "Springer Science and Business Media LLC", "reference": [ { "DOI": "10.1016/j.eclinm.2021.100986", "author": "X Jin", "doi-asserted-by": "publisher", "first-page": "100986", "journal-title": "EClinicalMedicine", "key": "816_CR1", "unstructured": "Jin X, Ren J, Li R, Gao Y, et al. 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