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Celiac.com 02/14/2022 - Prior studies have found links between the gut microbiome and COVID-19, along with other diseases. However, a new study by investigators at the Chinese University of Hong Kong offers the first published data specifically linking gut health to COVID's long-term effects. The research team assessed 106 patients with COVID-19 from February to August 2020, at three different hospitals, and compared their results against a group of patients recruited in 2019, who did not have COVID. Patients had mostly mild to moderate Covid severity. At 3 months, nearly ninety of the COVID patients had post–acute COVID-19 syndrome (PACS), which researchers defined as at least one persistent, otherwise unexplained symptom 4 weeks after testing negative for Covid. After six months, more than eighty patients still had PACS, with the main complaints being anxiety, fatigue, poor memory, hair loss, and difficulty sleeping. Stool sample analysis of PACS patients showed sharply lower bacteria diversity and abundance at six months, compared with with control subjects, and those without PACS. In patients with PACS, at both baseline and follow-up, nearly thirty bacteria species were reduced, while nearly fifteen were increased. Patients with COVID but not PACS showed just 25 changes to bacteria species at hospital intake, and all of those patients normalized by 6 months. The team linked patient respiratory symptoms at 6 months to higher levels of opportunistic pathogens such as Streptococcus anginosus and S. vestibularis. They also tied neuropsychiatric symptoms and fatigue to nosocomial pathogens, which are linked to opportunistic infections, such as Clostridium innocuum and Actinomyces naeslundii (P < .05). Bacteria that produce the beneficial fatty acid butyrate were substantially reduced in patients with hair loss. They also found that specific bacteria, including Bifidobacterium pseudocatenulatum and Faecalibacterium prausnitzii, showed the greatest inverse correlations with PACS at 6 months.. "Particular gut microbial profiles may indicate heightened susceptibility," said Dr Siew Ng, MBBS, PhD, associate director at the university's Center for Gut Microbiota Research. "Although the findings were drawn from patients with earlier strains of the COVID-19 virus, the findings still apply to new variants, including Omicron, since these pose the same problem of persistent disruption of the immune system," Ng adds. Dr Ng's group is currently carrying out trials to assess how long COVID might be prevented, and antibodies boosted, by modulating the microbiome after vaccination in high-risk people. "To our knowledge, this is the first study to show that altered gut microbiome composition is strongly associated with persistent symptoms in patients with COVID-19 up to 6 months after clearance of SARS-CoV-2 virus," said Dr Ng. Meanwhile, Eugene Chang, MD, professor of medicine at the University of Chicago, who has studied the gut microbiome and gastrointestinal disease, cautions that the study is "too preliminary" to lead to any clinical changes. Dr. Chang notes that the observations merely identify the microbes present, not their actual effects. Stay tuned for more on this and related stories about celiac disease and Covid. Read more in Medscape Medical News

Celiac.com 12/27/2021 - To better understand the rates of hospitalization, mortality, thrombosis or intensive care unit (ICU) treatment in individuals with celiac disease and COVID-19, a team of researchers recently set out to assess the clinical characteristics, hospitalization and mortality rates of COVID-19 among U.S. celiac disease patients. The research team included Emad Mansoor, Muhammed Mustafa Alikhan, Jaime Abraham Perez, Kayla Schlick, Mohannad Abou Saleh, and Dr Alberto Rubio-Tapia. They are variously affiliated with the Department of Medicine; Digestive Health Institute, University Hospitals of Cleveland, Cleveland, Ohio, USA; the Department of Medicine, University Hospitals of Cleveland, Cleveland, Ohio, USA; the Center for Clinical Research, Case Western Reserve University, Cleveland, Ohio, USA, Department of Medicine; the Division of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic, Cleveland, Ohio, USA. The team notes that their work was sparked, in part, by Belli et al1 regarding outcomes of COVID-19 in liver transplant candidates. The authors in Belli et al concluded that liver transplant candidates were at risk of early death, especially those with decompensated cirrhosis and model for end-stage liver disease score of 15 or above. That research team reviewed clinical outcomes in celiac patients after a diagnosis of COVID-19. Although the evidence of COVID-19's impact of other chronic disorders is emerging, researchers still don't know very much about the consequences of COVID-19 infection in people with celiac disease. To compile the celiac disease cohort, the team used the TriNetX healthcare research network to compile the electronic medical records of adults with celiac disease, and confirmed COVID-19 infection, from 51 healthcare organizations in the USA, between 1 January 2020 and 7 July 2021. For the non-celiac disease cohort, they also identified COVID-19 positive patients, with no history of celiac disease, from the same time period. They defined celiac disease by the International Classification of Disease, 10th Revision (celiac disease-10) diagnostic code and related codes, such as villous atrophy present on biopsy of small intestine and positive autoantibody screening. For both groups, the team studied the risk of hospitalization, mortality, thrombosis, and ICU requirement within 90 days of COVID-19 diagnosis. They also performed 1:1 propensity score matching using a greedy nearest-neighbor matching algorithm to account for potential confounding variables. Overall, the researchers found no significant differences among any of the measured outcomes in those with celiac disease, compared with non-celiac patients with COVID-19, after propensity score matching. Understanding more about COVID-19 outcomes of patients with celiac disease will researchers and patients to get a better idea of any potential concerns or options, and potentially lead to better outcomes. Read the full findings in Gut. Reference: Belli LS, Duvoux C, Cortesi PA, et al. COVID-19 in liver transplant candidates: pretransplant and post-transplant outcomes - an ELITA/ELTR multicentre cohort study. Gut 2021;70:10.1136/gutjnl-2021-324879:1914–24. doi:10.1136/gutjnl-2021-324879

Celiac.com 03/15/2021 - COVID-19 is mainly a respiratory illness, but there is mounting evidence to indicate that the gut and gut microbiota may play a role in the disease. A team of researchers recently set out to determine if the gut microbiome is linked to disease severity in patients with COVID-19, and whether variations in microbiome composition might resolve with the passing of the SARS-CoV-2 virus. The research team included Yun Kit Yeoh, Tao Zuo; Grace Chung-Yan Lui; Fen Zhang; Qin Liu; Amy YL Li; Arthur CK Chung; Chun Pan Cheung; Eugene YK Tso; Kitty SC Fung; Veronica Chan; Lowell Ling; Gavin Joynt; David Shu-Cheong Hui; Kai Ming Chow; Susanna So Shan Ng; Timothy Chun-Man Li; Rita WY Ng; Terry CF Yip; Grace Lai-Hung Wong; Francis KL Chan; Chun Kwok Wong; Paul KS Chan; and Siew C Ng. To get the answers, the team reviewed blood, stool and patient records from 100 patients with laboratory-confirmed SARS-CoV-2 infection, from two different hospitals. They collected serial stool samples from 27 of the 100 patients up to 30 days after the resolution of SARS-CoV-2. They assessed gut microbiome composition by shotgun sequencing total DNA from stool extraction. They then measured plasma concentrations of inflammatory cytokines and blood markers. Compared with non-COVID-19 patients, those with COVID-19 showed a substantially changed gut microbiome, whether or not they received medication. In COVID-19 patients, a number of gut microbiota with known immunomodulatory potential, such as Faecalibacterium prausnitzii, Eubacterium rectale and bifidobacteria were low, and remained low up to 30 days after Covid-19 abated. In these cases, Covid-19 severity reflected elevated concentrations of inflammatory cytokines and blood markers such as C reactive protein, lactate dehydrogenase, aspartate aminotransferase and gamma-glutamyl transferase. The connections between gut microbiota composition, levels of cytokines and inflammatory markers in patients with COVID-19 suggest that gut microbiota composition reflects disease severity and weakened immune responses. Moreover, because gut microbiota imbalance after Covid-19 resolution may lead to persistent symptoms, it is important to understand how gut microorganisms are involved in inflammation and COVID-19. Read more in Gut The researchers are variously affiliated with the Department of Microbiology, The Chinese University of Hong Kong, Shatin, Hong Kong; the Center for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong; the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong; the State Key Laboratory for digestive disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong; the Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Hong Kong; the Department of Pathology, United Christian Hospital, Kwun Tong, Hong Kong; the Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong; the Department of Chemical Pathology, The Chinese University of Hong Kong, Shatin, Hong Kong; the Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong.

Celiac.com 03/01/2021 - Although COVID-19 mainly affects the respiratory system, growing evidence indicates that the GI tract also plays a role in the disease. A team of researchers recently set out to determine if the gut microbiome is connected to disease severity in patients with Covid-19, and whether changes in microbiome composition might return to normal with the clearance of the SARS-CoV-2 virus. Here's what they found. The research team included Yun Kit Yeoh; Tao Zuo; Grace Chung-Yan Lui; Fen Zhang; Qin Liu; Amy YL Li; Arthur CK Chung; Chun Pan Cheung; Eugene YK Tso; Kitty SC Fung; Veronica Chan; Lowell Ling; Gavin Joynt; David Shu-Cheong Hui; Kai Ming Chow, Susanna So Shan Ng; Timothy Chun-Man Li; Rita WY Ng; Terry CF Yip; Grace Lai-Hung Wong; Francis KL Chan; Chun Kwok Wong; Paul KS Chan; and Siew C Ng. For their study, the team reviewed blood, stool and data from 100 patients with laboratory-confirmed SARS-CoV-2 infection. They collected serial stool samples from 27 of the 100 patients up to 30 days after clearance of SARS-CoV-2. To assess gut microbiome compositions, they shotgun sequenced total DNA extracted from stools. They measured concentrations of inflammatory cytokines and blood markers from plasma. Compared with non-Covid-19 individuals. Patients with COVID-19 showed substantially changed gut microbiome composition, with or without taking medication. Several gut bacteria with known immunomodulatory potential, such as Faecalibacterium prausnitzii, Eubacterium rectale and bifidobacteria, were significantly reduced in patients and remained low for up to a month after Covid-19 resolution. This altered gut microbiome displayed stratification with disease severity via elevated concentrations of inflammatory cytokines and blood markers such as C reactive protein, lactate dehydrogenase, aspartate aminotransferase and gamma-glutamyl transferase. The connections between gut microbiota levels, cytokines and inflammatory markers in Covid-19 patients indicate that the gut microbiome plays a significant role in Covid-19 severity possibly by modulating host immune responses. The researchers suggest that gut microbiota imbalance after Covid-19 resolution could contribute to ongoing symptoms, making it important to determine the role of gut microorganisms in inflammation and Covid-19. Read more in Gut. The researchers are variously affiliated with the Department of Microbiology, The Chinese University of Hong Kong, Shatin, Hong Kong; the Center for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong; the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong; the State Key Laboratory for digestive disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong; the Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong; the Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Hong Kong; the Department of Pathology, United Christian Hospital, Kwun Tong, Hong Kong; the Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong; the Department of Chemical Pathology, The Chinese University of Hong Kong, Shatin, Hong Kong; and the Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong.