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Metformin Therapy Changes Gut Microbiota Alpha-Diversity in COVID-19 Patients with Type 2 Diabetes: The Role of SARS-CoV-2 Variants and Antibiotic Treatment

Petakh et al., MDPI AG, doi:10.20944/preprints202304.1127.v1
Apr 2023  
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Retrospective 120 hospitalized COVID-19 patients showing lower alpha diversity of gut microbiota associated with antibiotic use, type 2 diabetes, longer hospital stays, higher CRP levels, and higher NLR. Metformin therapy was associated with increased alpha diversity. There was no significant difference in diversity between delta and omicron groups. Authors suggest that maintaining a diverse gut microbiota may benefit COVID-19 patients with type 2 diabetes.
Petakh et al., 28 Apr 2023, Ukraine, preprint, 5 authors. Contact: (corresponding author),
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Metformin Therapy Changes Gut Microbiota Alpha-Diversity in COVID-19 Patients with Type 2 Diabetes: The Role of SARS-CoV-2 Variants and Antibiotic Treatment
Pavlo Petakh, Iryna Kamyshna, Valentyn Oksenych, Denis Kainov, Aleksandr Kamyshnyi
The gut microbiota plays a crucial role in maintaining host health and has a significant impact on human health and disease. In this study, we investigated the alpha diversity of gut microbiota in COVID-19 patients and analyzed the impact of COVID-19 variants, antibiotic treatment, type 2 diabetes (T2D), and metformin therapy on gut microbiota composition and diversity. We used a culture-based method to analyze the gut microbiota and calculated alphadiversity using the Shannon H' and Simpson 1/D indices. We collected clinical data, such as length of hospital stay (LoS), C-reactive protein (CRP) levels, and neutrophil-to-lymphocyte ratio. We found that patients with T2D had significantly lower alpha-diversity than those without T2D. Antibiotic use was associated with a reduction in alpha-diversity, while metformin therapy was associated with an increase. We did not find significant differences in alpha-diversity between the Delta and Omicron groups. Length of hospital stay, CRP levels, and NLR showed weak to moderate correlations with alpha diversity. Our findings suggest that maintaining a diverse gut microbiota may benefit COVID-19 patients with T2D. Interventions aimed at preserving or restoring gut microbiota diversity, such as avoiding unnecessary antibiotic use and promoting metformin therapy, may improve patient outcomes.
Author Contributions: Conceptualization, A.K.; methodology, A.K. and P.P..; software, A.K. and P.P.; validation, A.K., P.P. and I.K.; formal analysis, I.K.; investigation, P.P.; resources, A.K.; data curation, A.K.; writing-original draft preparation, P.P.; writing-review and editing, A.K., V.O., D.K.; visualization, P.P. and A.K.; supervision, A.K.; project administration, A.K.. All authors have read and agreed to the published version of the manuscript. Institutional Review Board Statement: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of Uzhhorod National Univesrity (11.02.20/11ab) Informed Consent Statement: Informed consent was obtained from all subjects involved in the study. Conflicts of Interest: The authors declare no conflict of interest.
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