Safety and efficacy of probiotic supplements as adjunctive therapies in patients with COVID-19: A systematic review and meta-analysis
Julie Zhu, Tyler Pitre, Carmen Ching, Dena Zeraatkar, Steven Gruchy
PLOS ONE, doi:10.1371/journal.pone.0278356
Background and aims Oral probiotic supplementation may be a beneficial adjunctive therapy for patients with symptomatic COVID-19. However, its safety and efficacy are unclear. We aimed to investigate how probiotic supplementation impacts COVID-19 symptom trajectory and patient outcomes by conducting a systematic review and meta-analysis of randomized controlled trials (RCTs).
Methods RCTs randomizing patients with COVID-19 to probiotics were searched in PubMed Central, Embase, CINAHL, and Cochrane Library from inception to July 31, 2022. We performed a random-effects pairwise meta-analysis for all outcomes using the restricted maximum likelihood (REML) estimator. We used the GRADE approach to assess the certainty of the evidence.
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doi:10.1177/17562848211035670{ 'indexed': {'date-parts': [[2024, 1, 5]], 'date-time': '2024-01-05T06:02:47Z', 'timestamp': 1704434567639},
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'abstract': '<jats:sec id="sec001">\n'
'<jats:title>Background and aims</jats:title>\n'
'<jats:p>Oral probiotic supplementation may be a beneficial adjunctive therapy for patients '
'with symptomatic COVID-19. However, its safety and efficacy are unclear. We aimed to '
'investigate how probiotic supplementation impacts COVID-19 symptom trajectory and patient '
'outcomes by conducting a systematic review and meta-analysis of randomized controlled trials '
'(RCTs).</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec002">\n'
'<jats:title>Methods</jats:title>\n'
'<jats:p>RCTs randomizing patients with COVID-19 to probiotics were searched in PubMed '
'Central, Embase, CINAHL, and Cochrane Library from inception to July 31, 2022. We performed a '
'random-effects pairwise meta-analysis for all outcomes using the restricted maximum '
'likelihood (REML) estimator. We used the GRADE approach to assess the certainty of the '
'evidence.</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec003">\n'
'<jats:title>Results</jats:title>\n'
'<jats:p>A total of 1027 participants from eight RCT studies were included in the '
'meta-analysis. Probiotic supplements probably reduce the incidence of diarrhea (RR 0.61 [0.43 '
'to 0.87]; moderate certainty) and probably reduce cough or dyspnea compared to '
'placebo/standard care (RR 0.37 [0.19 to 0.73]; moderate certainty). Probiotic supplements may '
'improve composite endpoint measured by clinical escalation or mortality compared to placebo '
'(RR 0.41 [0.18 to 0.93]; low certainty evidence); however, they may not significantly reduce '
'the need for clinical escalation (RR 0.57 [0.31 to 1.07]; low certainty evidence) or '
'mortality (RR 0.50 [0.20 to 1.29]; low certainty evidence). In addition, the probiotic '
'supplement is associated with reduced adverse events (RR 0.62 [0.46 to 0.83]; moderate '
'certainty).</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec004">\n'
'<jats:title>Conclusion</jats:title>\n'
'<jats:p>Early probiotic supplement is a safe and effective adjunctive therapy that reduces '
'the risk of symptoms and health care burden related to COVID-19 across all severity '
'types.</jats:p>\n'
'</jats:sec>',
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