Dysbiosis of gut microbiota in patients with severe COVID‐19
Kentaro Shimizu, Haruhiko Hirata, Natsuko Tokuhira, Daisuke Motooka, Shota Nakamura, Akiko Ueda, Jotaro Tachino, Moe Koide, Akinori Uchiyama, Hiroshi Ogura, Jun Oda
Acute Medicine & Surgery, doi:10.1002/ams2.923
BACKGROU N D The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) pandemic is an emergency situation throughout the world. COVID-19 has been reported to cause inflammation and cytokine storm and lead to multiple organ dysfunction syndrome. 1 The gut has been a target organ following critical illnesses. 2 Cross talk between the intestinal epithelium, immune system, and commensal bacteria is central to initiating the systemic inflammatory response. The gut-lung axis has been proposed as one of the causes of the exacerbation of disease severity. 3 The human gut microbiota is estimated to contain 10 14 microbes comprising over 1000 different bacterial species that reside in the host's colon. 4 These bacteria have a close connection with human metabolism and homeostasis of the immune system. Dysbiosis, defined as an imbalance in the microbial communities living in or on the body, 5 leads to various diseases such as obesity, metabolic syndrome, cardiovascular diseases, cancer, and autoimmune diseases. In the acute phase of critical care, gut
CONCLUSION In conclusion, the commensal gut microbiota in patients with severe COVID-19 infection was altered, and opportunistic bacteria increased within several days from disease onset.
ACKNOWLEDGMENTS The study was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Numbers 19H03761 and 22H03174. The authors acknowledge the contributions made by all of the staff in Osaka University Hospital who aided in this research and are involved COVID-19 medical practice.
C ON F L IC T OF I N T E R E S T S TAT E M E N T Dr. Hiroshi Ogura is an Editorial Board member of the AMS Journal and a coauthor of this article. To minimize bias, they were excluded from all editorial decision-making related to the acceptance of this article for publication. Dr. Jun Oda is Editor-in-Chief of the journal and coauthor of this article. They were excluded from the peer-review process and all editorial decisions related to the acceptance and publication of this article. Peer-review was handled independently by Acute Medicine and Surgery editorial office with Dr. Yasuyuki Kuwagata as the Editor to minimize bias.
DATA AVA I L A BI L I T Y S TAT E M E N T The data that support the findings of this study are available from the corresponding author upon reasonable request.
A PPROVA L OF T H E R E SE A RC H PRO T O C OL Approval of the research protocol: This study was approved by the institutional review board of Osaka University Hospital (approval number: 12035).
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