Treating the gut microbiome may encourage faster recovery from post-acute COVID-19 (PACS), or long COVID, with new research demonstrating a strong association between gut dysbiosis and long standing symptoms in patients with COVID-19 up to six months after virus clearance.
With an increasing population of patients recovering from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there is significant interest in understanding and treating the phenomenon of ‘long COVID’ or PACS, a collection of mild to chronic symptoms that persist weeks to months after initial infection.
The exact cause of long COVID is still yet to be concluded; however, possible causative factors include over active immune response, ongoing inflammation, cellular damage during acute infection, and physical effects of severe illness. In addition, a recent study identified 4 factors potentially involved in causing long COVID:
Existing type 2 diabetes - If you have pre-existing type 2 diabetes you could be at risk of contracting long COVID, according to the study. Researchers warned it is likely only one of several other pre-existing medical conditions that could increase the risk of contracting long COVID.
Circulating fragments of SARS-CoV-2 at the time of diagnosis - A large amount of coronavirus RNA found in a person’s bloodstream early on during the disease could mean they are more at risk of getting long COVID.
Reactivation of the Epstein-Barr virus - The Epstein-Barr virus can cause mononucleosis, but usually stays dormant in the body. Having this virus, reactivated in your system at the time you are diagnosed with COVID-19, was correlated with an increase in risk of contracting long COVID, according to the study.
The presence of specific autoantibodies directed against a person’s own tissue or organs. Autoantibodies are created by a person’s immune system, but directed to attack their own tissue or organs. A larger presence of some autoantibodies in the body could indicate that a person has lower levels of protective antibodies against COVID.
Research has found that individuals who experience severe COVID-19 tend to present with gut dysbiosis, characterised by reduced microbiota diversity, increased abundance of opportunistic pathogens, and fewer gut commensals with immunomodulatory effects.
Whats more is, gut dysbiosis may persist long after virus clearance and has been linked to disease severity, impaired pulmonary function, and inflammatory reaction in follow-up studies of COVID-19 patients at 3 and 6 months.
Higher levels of Ruminoccocus gnavus and Bacteroides vulgaris characterised the gut microbiome of patients with long COVID. These bacteria are often associated with inflammatory diseases. These patients also had lower levels of Faecalibacterium prausnitzii. As a major member of the human microbiome, F. prausnitzii is a multiskilled commensal organism and has a variety of biological functions, such as regulating the immune response, suppressing inflammation, and promoting the integrity of the intestinal barrier.
Persistent respiratory symptoms were correlated with opportunistic gut pathogens, including Streptococcus anginosus, Streptococcus vestibularis, Streptococcus gordonii and Clostridium disporicum. Neuropsychiatric symptoms and fatigue were correlated with nosocomial gut pathogens, including Clostridium innocuum and Actinomyces naeslundii. Bacteria known for producing butyrate, a beneficial fatty acid, were significantly depleted in those patients with hair loss.
If you are experiencing persistent long covid symptoms even after extensive treatment, I strongly suggest getting in touch and organising a stool test to get a better insight to whats going on with your microbiome.
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