Probiotics use is associated with improved clinical outcomes among hospitalized patients with COVID-19
Zhang et al.
, Probiotics use is associated with improved clinical outcomes among hospitalized patients with COVID-19
, Therapeutic Advances in Gastroenterology, doi:10.1177/17562848211035670
Retrospective 375 patients in China, 179 treated with probiotics (Bifidobacterium, Lactobacillus, and Enterococcus), showing improved clinical outcomes with treatment.
The immune effects of probiotics are strain-specific.
hospitalization time, 13.6% lower, relative time 0.86, p = 0.009, treatment 150, control 150, PSM.
time to clinical improvement, 14.3% lower, relative time 0.86, p = 0.02, treatment 150, control 150, PSM.
time to viral-, 16.7% lower, relative time 0.83, p < 0.001, treatment 150, control 150, PSM.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Zhang et al., 4 Aug 2021, retrospective, China, peer-reviewed, 14 authors.
TAG0010.1177/17562848211035670Therapeutic Advances in GastroenterologyL Zhang, H Han
Therapeutic Advances in Gastroenterology
Probiotics use is associated with improved
clinical outcomes among hospitalized
patients with COVID-19
Ther Adv Gastroenterol
2021, Vol. 14: 1–9
© The Author(s), 2021.
Article reuse guidelines:
Lina Zhang*, Huanqin Han*, Xuan Li*, Caozhen Chen*, Xiaobing Xie, Guomei Su,
Shicai Ye, Cuili Wang, Qing He, Fang Wang, Fang Huang, Zhaoqin Wang, Jiayuan Wu
and Tianwen Lai
Background and aims: Currently, there are no definitive therapies for coronavirus disease
2019 (COVID-19). Gut microbial dysbiosis has been proved to be associated with COVID-19
severity and probiotics is an adjunctive therapy for COIVD-19. However, the potential benefit of
probiotics in COVID-19 has not been studied. We aimed to assess the relationship of probiotics
use with clinical outcomes in patients with COVID-19.
Methods: We conducted a propensity-score matched retrospective cohort study of adult
patients with COVID-19. Eligible patients received either probiotics plus standard care
(probiotics group) or standard care alone (non-probiotics group). The primary outcome was
the clinical improvement rate, which was compared among propensity-score matched groups
and in the unmatched cohort. Secondary outcomes included the duration of viral shedding,
fever, and hospital stay.
Results: Among the propensity-score matched groups, probiotics use was related to clinical
improvement rates (log-rank p = 0.028). This relationship was driven primarily by a shorter
(days) time to clinical improvement [difference, −3 (−4 to −1), p = 0.022], reduction in duration
of fever [−1.0 (−2.0 to 0.0), p = 0.025], viral shedding [−3 (−6 to −1), p < 0.001], and hospital stay
[−3 (−5 to −1), p = 0.009]. Using the Cox model with time-varying exposure, use of probiotics
remained independently related to better clinical improvement rate in the unmatched cohort.
Conclusion: Our study suggested that probiotics use was related to improved clinical
outcomes in patients with COVID-19. Further studies are required to validate the effect of
probiotics in combating the COVID-19 pandemic.
Keywords: clinical improvement, COVID-19, gut microbiota, probiotics
Received: 11 April 2021; revised manuscript accepted: 29 June 2021.
is less effective
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation. FLCCC
provide treatment protocols.