COVID-19 Pneumonia and Gut Inflammation: The Role of a Mix of Three Probiotic Strains in Reducing Inflammatory Markers and Need for Oxygen Support
Saviano et al.
, COVID-19 Pneumonia and Gut Inflammation: The Role of a Mix of Three Probiotic Strains in Reducing Inflammatory..
, Journal of Clinical Medicine, doi:10.3390/jcm11133758
RCT 80 COVID-19 interstitial pneumonia patients in Italy, 40 treated with probiotics, showing significantly reduced gut inflammatory markers with treatment, and lower ICU admission and mortality, without statistical significance. Bifidobacterium lactis LA 304, lactobacillus salivarius LA 302, and lactobacillus acidophilus LA 201 bid for 10 days.
The immune effects of probiotics are strain-specific.
Although the 67% lower mortality is not statistically significant, it is consistent with the significant 61% lower mortality [37‑76%]
from meta analysis of the 8 mortality results to date
risk of death, 66.7% lower, RR 0.33, p = 1.00, treatment 0 of 40 (0.0%), control 1 of 40 (2.5%), NNT 40, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of ICU admission, 85.7% lower, RR 0.14, p = 0.24, treatment 0 of 40 (0.0%), control 3 of 40 (7.5%), NNT 13, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
hospitalization time, 26.3% lower, relative time 0.74, p = 0.52, treatment mean 14.0 (±6.0) n=40, control mean 19.0 (±10.0) n=40.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Saviano et al., 28 Jun 2022, Randomized Controlled Trial, Italy, peer-reviewed, mean age 59.8, 9 authors.
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Abstract: Journal of
COVID-19 Pneumonia and Gut Inflammation: The Role of a
Mix of Three Probiotic Strains in Reducing Inflammatory
Markers and Need for Oxygen Support
Angela Saviano 1 , Annalisa Potenza 2 , Valentina Siciliano 3 , Carmine Petruzziello 4 , Claudia Tarli 2 ,
Alessio Migneco 1 , Flavia Nasella 1 , Francesco Franceschi 1 and Veronica Ojetti 1, *
Citation: Saviano, A.; Potenza, A.;
Siciliano, V.; Petruzziello, C.; Tarli, C.;
Migneco, A.; Nasella, F.; Franceschi,
F.; Ojetti, V. COVID-19 Pneumonia
and Gut Inflammation: The Role of a
Mix of Three Probiotic Strains in
Reducing Inflammatory Markers and
Need for Oxygen Support. J. Clin.
Med. 2022, 11, 3758. https://doi.org/
Academic Editors: Uri Kopylov and
Received: 14 May 2022
Accepted: 26 June 2022
Published: 28 June 2022
Publisher’s Note: MDPI stays neutral
Emergency Medicine Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00165 Rome, Italy;
email@example.com (A.S.); firstname.lastname@example.org (A.M.);
email@example.com (F.N.); firstname.lastname@example.org (F.F.)
Internal Medicine Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00165 Rome, Italy;
email@example.com (A.P.); firstname.lastname@example.org (C.T.)
Department of Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli, IRCCS,
00165 Rome, Italy; email@example.com
Emergency Medicine Department, Ospedale San Carlo di Nancy, 00165 Rome, Italy;
Abstract: Background: COVID-19 disease, which typically presents with respiratory symptoms,
can trigger intestinal inflammation through SARS-CoV-2 replication in the gastrointestinal tract.
Supplementation with probiotics may have beneficial effects on gut inflammation due to their
analgesic and anti-inflammatory properties. The primary objective of our study was to evaluate
the efficacy of a mix of three probiotic strains (Bifidobacterium lactis LA 304, Lactobacillus salivarius
LA 302, and Lactobacillus acidophilus LA 201; Lactibiane Iki® ) in the reduction in fecal calprotectin
in patients with COVID-19 pneumonia, compared to a control group. The secondary aim was to
evaluate the reduction in oxygen support and length of hospital stay in patients taking the probiotic
mix. Patients and Methods: We conducted a prospective randomized controlled trial at Fondazione
Policlinico Gemelli, Rome. We enrolled patients with COVID-19 interstitial pneumonia. One group
received the probiotic mix twice a day for 10 days in addition to the standard COVID-19 therapy,
and a second group received standard COVID-19 therapy without probiotics. We administered
oxygen support (through Ventimask or Optiflow® ) on days (D) 1, 3, 5, 7 and 10, and the level of
fecal calprotectin between D3–D5 and D7–D10. Results: A total of 80 patients (44 M/36 F; mean
age: 59.8 ± 17.3) were enrolled with a mean value of calprotectin at enrollment of 140 mg/dL. At
D7–10, the probiotic group showed a 35% decrease in fecal calprotectin compared to 16% in the
control group, a decrease in C-reactive protein (CRP) of 72.7% compared to 62%, and a slight but not
significant decrease in oxygen support compared to the control group. Conclusion: Supplementation
with a mix of probiotics for 10 days in patients with COVID-19 interstitial..
is less effective
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