Targeting Microbiome: An Alternative Strategy for Fighting SARS-CoV-2 Infection

Ornella Spagnolello; Claudia Pinacchio; Letizia Santinelli; Paolo Vassalini; Giuseppe Pietro Innocenti; Gabriella De Girolamo; Silvia Fabris; Marta Giovanetti; Silvia Angeletti; Alessandro Russo; Claudio M Mastroianni; Massimo Ciccozzi; Giancarlo Ceccarelli; Gabriella d'Ettorre

doi:10.1159/000515344

Targeting Microbiome: An Alternative Strategy for Fighting SARS-CoV-2 Infection

Chemotherapy. 2021;66(1-2):24-32. doi: 10.1159/000515344. Epub 2021 Mar 23.

Authors

Ornella Spagnolello¹, Claudia Pinacchio¹, Letizia Santinelli¹, Paolo Vassalini¹, Giuseppe Pietro Innocenti¹, Gabriella De Girolamo^{1

2}, Silvia Fabris³, Marta Giovanetti^{3

4

5}, Silvia Angeletti⁶, Alessandro Russo^{1

2}, Claudio M Mastroianni^{1

2}, Massimo Ciccozzi³, Giancarlo Ceccarelli^{7

8

9}, Gabriella d'Ettorre^{1

2}

Affiliations

¹ Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
² COVID-19 Unit, Azienda Policlinico "Umberto I" University Hospital, Rome, Italy.
³ Medical Statistic and Molecular Epidemiology Unit, University of Biomedical Campus, Rome, Italy.
⁴ Laboratório de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
⁵ Laboratório de Genética Celular e Molecular, ICB, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
⁶ Unit of Clinical Laboratory Science, University of Biomedical Campus, Rome, Italy.
⁷ Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy, giancarlo.ceccarelli@uniroma1.it.
⁸ COVID-19 Unit, Azienda Policlinico "Umberto I" University Hospital, Rome, Italy, giancarlo.ceccarelli@uniroma1.it.
⁹ Migrant and Global Health Research Organization (Mi-HeRo), Rome, Italy, giancarlo.ceccarelli@uniroma1.it.

Abstract

Respiratory and gastrointestinal symptoms are the predominant clinical manifestations of the coronavirus disease 2019 (COVID-19). Infecting intestinal epithelial cells, the severe acute respiratory syndrome coronavirus-2 may impact on host's microbiota and gut inflammation. It is well established that an imbalanced intestinal microbiome can affect pulmonary function, modulating the host immune response ("gut-lung axis"). While effective vaccines and targeted drugs are being tested, alternative pathophysiology-based options to prevent and treat COVID-19 infection must be considered on top of the limited evidence-based therapy currently available. Addressing intestinal dysbiosis with a probiotic supplement may, therefore, be a sensible option to be evaluated, in addition to current best available medical treatments. Herein, we summed up pathophysiologic assumptions and current evidence regarding bacteriotherapy administration in preventing and treating COVID-19 pneumonia.

Keywords: COVID-19; Dysbiosis; Gut-lung axis; Probiotics; Systemic cytokine storm.

Publication types

Review

MeSH terms

COVID-19* / immunology
COVID-19* / physiopathology
COVID-19* / prevention & control
Dietary Supplements
Dysbiosis* / therapy
Dysbiosis* / virology
Gastrointestinal Microbiome / immunology*
Humans
Probiotics / pharmacology*
SARS-CoV-2