COVID-19 Pneumonia and Gut Inflammation: The Role of a Mix of Three Probiotic Strains in Reducing Inflammatory Markers and Need for Oxygen Support

DOI record: { "DOI": "10.3390/jcm11133758", "ISSN": [ "2077-0383" ], "URL": "http://dx.doi.org/10.3390/jcm11133758", "abstract": "<jats:p>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 pneumonia significantly reduces inflammatory markers.</jats:p>", "alternative-id": [ "jcm11133758" ], "author": [ { "affiliation": [], "family": "Saviano", "given": "Angela", "sequence": "first" }, { "affiliation": [], "family": "Potenza", "given": "Annalisa", "sequence": "additional" }, { "affiliation": [], "family": "Siciliano", "given": "Valentina", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0003-1025-1092", "affiliation": [], "authenticated-orcid": false, "family": "Petruzziello", "given": "Carmine", "sequence": "additional" }, { "affiliation": [], "family": "Tarli", "given": "Claudia", "sequence": "additional" }, { "affiliation": [], "family": "Migneco", "given": "Alessio", "sequence": "additional" }, { "affiliation": [], "family": "Nasella", "given": "Flavia", "sequence": "additional" }, { "affiliation": [], "family": "Franceschi", "given": "Francesco", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-8953-0707", "affiliation": [], "authenticated-orcid": false, "family": "Ojetti", "given": "Veronica", "sequence": "additional" } ], "container-title": "Journal of Clinical Medicine", "container-title-short": "JCM", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2022, 6, 29 ] ], "date-time": "2022-06-29T05:48:38Z", "timestamp": 1656481718000 }, "deposited": { "date-parts": [ [ 2022, 7, 1 ] ], "date-time": "2022-07-01T08:06:10Z", "timestamp": 1656662770000 }, "indexed": { "date-parts": [ [ 2022, 7, 1 ] ], "date-time": "2022-07-01T08:43:28Z", "timestamp": 1656665008906 }, "is-referenced-by-count": 0, "issue": "13", "issued": { "date-parts": [ [ 2022, 6, 28 ] ] }, "journal-issue": { "issue": "13", "published-online": { "date-parts": [ [ 2022, 7 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2022, 6, 28 ] ], "date-time": "2022-06-28T00:00:00Z", "timestamp": 1656374400000 } } ], "link": [ { "URL": "https://www.mdpi.com/2077-0383/11/13/3758/pdf", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "1968", "original-title": [], "page": "3758", "prefix": "10.3390", "published": { "date-parts": [ [ 2022, 6, 28 ] ] }, "published-online": { "date-parts": [ [ 2022, 6, 28 ] ] }, "publisher": "MDPI AG", "reference": [ { "article-title": "When COVID-19 encounters interstitial lung disease: Challenges and management", "author": "Ren", "first-page": "E039", "journal-title": "Zhonghua Jie He He Hu Xi Za Zhi", "key": "ref1", "volume": "43", "year": "2020" }, { "DOI": "10.47102/annals-acadmedsg.202051", "doi-asserted-by": "publisher", "key": "ref2" }, { "DOI": "10.1007/s00330-020-06801-0", "doi-asserted-by": "publisher", "key": "ref3" }, { "DOI": "10.1186/s41256-020-00135-6", "doi-asserted-by": "publisher", "key": "ref4" }, { "article-title": "A rapid advice guideline for the diagnosis and treatment of 2019 novel coro-navirus (2019-nCoV) infected pneumonia", "author": "Jin", "first-page": "4", "journal-title": "Mil. 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