Skip to main content Accessibility help
×
Home
Hostname: page-component-55b6f6c457-kv5sj Total loading time: 0.225 Render date: 2021-09-26T10:54:58.187Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Beyond probiotic legend: ESSAP gut microbiota health score to delineate SARS-COV-2 infection severity

Published online by Cambridge University Press:  07 June 2021

Mona Hegazy*
Affiliation:
Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Omar Ahmed Ashoush
Affiliation:
Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Mohamed Tharwat Hegazy
Affiliation:
Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Mahmoud Wahba
Affiliation:
Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Rania M. Lithy
Affiliation:
Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Hoda M. Abdel-Hamid
Affiliation:
Chest Diseases Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Samah Ahmed Abd elshafy
Affiliation:
Nutrition and Food Science Department, Faculty of Home Economics, Al-Azhar University, Cairo, Egypt
Dalia Abdelfatah
Affiliation:
Biostatistics and Cancer Epidemiology Department, National Cancer Institute, Cairo University, Cairo, Egypt
Maha Hossam El-Din Ibrahim
Affiliation:
Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Ahmed Abdelghani
Affiliation:
Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
*
*Corresponding author: Mona Hegazy, email monahegazy@cu.edu.eg

Abstract

COVID-19 pandemic continues to be a global health crisis. The gut microbiome critically affects the immune system, and some respiratory infections are associated with changes in the gut microbiome; here, we evaluated the role of nutritional and lifestyle habits that modulate gut microbiota on COVID-19 outcomes in a longitudinal cohort study that included 200 patients infected with COVID-19. Of these, 122 cases were mild and seventy-eight were moderate, according to WHO classification. After detailed explanation by a consultant in clinical nutrition, participants responded to a written questionnaire on daily sugar, prebiotic intake in food, sleeping hours, exercise duration and antibiotic prescription, during the past 1 year before infection. Daily consumption of prebiotic-containing foods, less sugar, regular exercise, adequate sleep and fewer antibiotic prescriptions led to a milder disease and rapid virus clearance. Additionally, data on these factors were compiled into a single score, the ESSAP score (Exercise, Sugar consumption, Sleeping hours, Antibiotics taken, and Prebiotics consumption; 0–11 points), median ESSAP score was 5 for both mild and moderate cases; however, the range was 4–8 in mild cases, but 1–6 in moderate (P = 0·001, OR: 4·2, 95 % CI 1·9, 9·1); our results showed a negative correlation between regular consumption of yogurt containing probiotics and disease severity (P = 0·007, OR: 1·6, 95 % CI 1·1, 2·1). Mild COVID-19 disease was associated with 10–20 min of daily exercise (P = 0·016), sleeping at least 8 h daily, prescribed antibiotics less than 5 times per year (P = 0·077) and ate plenty of prebiotic-containing food.

Type
Full Papers
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

WHO (2021) Egypt: WHO Coronavirus Disease (COVID-19) Dashboard. https://covid19.who.int/region/emro/country/eg/ (accessed April 2021).Google Scholar
Pan, L, Mu, M, Yang, P, et al. (2020) Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, china. A descriptive, cross-sectional, multicenter study. Am J Gastroenterol 115, 766773.CrossRefGoogle Scholar
Groves, HT, Higham, SL, Moffatt, MF, et al. (2020) Respiratory viral infection alters the gut microbiota by inducing inappetence. mBio 11, e0323619.CrossRefGoogle ScholarPubMed
Maynard, CL, Rich, RR, Fleisher, TA, et al. (2019) The Microbiota in Immunity and Inflammation, Clinical Immunology, 5th ed., 207–219.e1, ISBN 9780702068966. Elsevier.Google Scholar
Negi, S, Das, DK, Pahari, S, et al. (2019) Potential role of gut microbiota in induction and regulation of innate immune memory. Front Immunol 10, 112.CrossRefGoogle ScholarPubMed
Round, JL & Mazmanian, SK (2010) Mazmanian Inducible Foxp3+ regulatory T-cell development by a commensal bacterium of the intestinal microbiota. Proc Natl Acad Sci 107, 1220412209.CrossRefGoogle ScholarPubMed
Dominika, Ś, Arjan, N, Karyn, RP, et al. (2011) The study on the impact of glycated pea proteins on human intestinal bacteria. Int J Food Microbiol 145, 267272.CrossRefGoogle Scholar
West, CE, Dzidic, M, Prescott, SL, et al. (2017) Bugging allergy; role of pre-, pro- and symbiotic in allergy prevention. Allergol Int 66, 529538.CrossRefGoogle Scholar
Trompette, A, Gollwitzer, ES, Yadava, K, et al. (2014) Gut microbiota metabolism of dietary fiber influences allergic airway disease and hematopoiesis. Nat Med 20, 159166.CrossRefGoogle ScholarPubMed
Quercia, S, Candela, M, Giuliani, C, et al. (2014) From lifetime to evolution: timescales of human gut microbiota adaptation. Front Microbiol 5, 587.CrossRefGoogle ScholarPubMed
Conlon, MA & Bird, AR (2015) The impact of diet and lifestyle on gut microbiota and human health. Nutrients 7, 1744.CrossRefGoogle Scholar
World Health Organization (2020) Clinical Management of COVID-19: Interim Guidance. https://www.who.int/publications/i/item/clinical-management-of-covid-19 (accessed May 2020).Google Scholar
Egypt Ministry of Health and Population (2020) Diagnosis and Treatment Protocol for COVID 19. Cairo: Egypt Ministry of Health and Population.Google Scholar
World Medical Association (2009) Declaration of Helsinki. Ethical principles for medical research involving human subjects. J Am Coll Dent 81, 1418.Google Scholar
Lourens-Hattingh, A & Viljoen, BC (2001) Yogurt as a probiotic carrier food. Int Dairy J 11, 117.CrossRefGoogle Scholar
Bassuoni, R, Soliman, M, Hussein, L, et al. (2019) Bio-efficiencies of probiotic yoghurt and fermented sour soya supplements on gut microbial health and other associated health biomarkers among Egyptian pre-school to school age children. Int J Clin Nutr Diet 5, 145.Google Scholar
Committee (DGAC) (2010) The Dietary Guidelines for Americans 2010 (USDA and HHS, 2011). https://health.gov/our-work/food-nutrition/previous-dietary-guidelines/2010 (accessed April 2021).Google Scholar
Elsheikh, EAE, El Tinay, AH & Fadul, IA (1999) Effect of nutritional status of fava bean on proximate composition, antinutritional factors and in vitro protein digestibility (IVPD). Food Chem 67, 379383.CrossRefGoogle Scholar
Frølich, W, Aman, P & Tetens, I (2013) Whole grain foods and health a Scandinavian perspective. Food Nutr Res 57, 18503.CrossRefGoogle Scholar
Johnson, RK, Appel, LJ, Brands, M, et al. (2009) Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation 120, 10111020.CrossRefGoogle ScholarPubMed
US Department of Health and Human Services (2008) Physical Activity Guidelines for Americans. Washington, DC: US Department of Health and Human Services.Google Scholar
Coakes, SJ & Steed, L (2009) SPSS: Analysis without Anguish using SPSS Ion 14.0 for Windows. Statistics in Medicine 18, 2984–2985.Google Scholar
Dominika, Ś, Arjan, N, Karyn, RP, et al. (2011) The study on the impact of glycated pea proteins on human intestinal bacteria. Int J Food Microbiol 145, 267272.CrossRefGoogle Scholar
Mogensen, TH (2009) Pathogen recognition and inflammatory signaling in innate immune defenses. Clin Microbiol Rev 22, 240273.CrossRefGoogle ScholarPubMed
Clemente, JC, Ursell, LK, Parfrey, LW, et al (2012) The impact of the gut microbiota on human health: an integrative view. Cell 148, 12581270.CrossRefGoogle Scholar
Groves, HT, Higham, SL, Moffatt, MF, et al, (2020) Respiratory viral infection alters the gut microbiota by inducing inappetence. mBio 11, 117.CrossRefGoogle ScholarPubMed
Perrotta, F, Corbi, G, Mazzeo, G, et al. (2020) COVID-19 and the elderly: insights into pathogenesis and clinical decision-making. Aging Clin Exp Res 32, 15991608.CrossRefGoogle ScholarPubMed
Zheng, Z, Peng, F, Xu, B, et al. (2020) Risk factors of critical & mortal COVID-19 cases: a systematic literature review and meta-analysis. J Infect 81, e16e25.CrossRefGoogle ScholarPubMed
Ellulu, MS, Patimah, I, Khaza’ai, H, et al. (2017) Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci 13, 851863.CrossRefGoogle ScholarPubMed
Everard, A, Belzer, C, Geurts, L, et al. (2013) ‘Cross-talk between Akkermansia muciniphila and intestinal epithelium controls diet-induced obesity’. Proc Natl Acad Sci 110, 90669071.CrossRefGoogle Scholar
Harsch, IA & Konturek, PC (2018) The role of gut microbiota in obesity and type 2 and type 1 diabetes mellitus: new insights into ‘Old’ diseases. Med Sci 6, 32.Google ScholarPubMed
Trompette, A, Gollwitzer, ES, Pattaroni, C, et al. (2018) Dietary fiber confers protection against flu by shaping Ly6c- patrolling monocyte hematopoiesis and CD8 T cell metabolism. Immunity 48, 9921005.CrossRefGoogle ScholarPubMed
Arrieta, MC, Meddings, J & Field, CJ (2011) The immunomodulatory effects of dietary fiber and prebiotics in the gastrointestinal tract. In Non digestible Carbohydrates and Digestive Health, pp. 3777 [Paeschke, TM & Aimutis, WR, editors]. Ames, IA: Blackwell Publishing Ltd. and Institute of Food Technologists.CrossRefGoogle Scholar
Schley, PD & Field, CJ (2007) The immune-enhancing effects of dietary fibers and prebiotics. Br J Nutr 87, 221230.CrossRefGoogle Scholar
Khan, TA & Sievenpiper, JL (2016) Controversies about sugars: results from systematic reviews and meta-analyses on obesity, cardiometabolic disease and diabetes. Eur J Nutr 55, 2543.CrossRefGoogle ScholarPubMed
Di Rienzi, SC & Britton, RA (2020) Adaptation of the gut microbiota to modern dietary sugars and sweeteners. Adv Nutr 11, 616629.CrossRefGoogle ScholarPubMed
Bermon, S, Petriz, B, Kajeniene, A, et al. (2015) ‘The microbiota: an exercise immunology perspective’. Exerc Immunol Rev 21, 7079.Google Scholar
Mika, A, Van Treuren, W, González, A, et al. (2015) ‘Exercise is more effective at altering gut microbial composition and producing stable changes in lean mass in juvenile v. adult male F344 rats’. PLoS ONE 10, e0125889.CrossRefGoogle Scholar
Matsumoto, M, Inoue, R, Tsukahara, T, et al., (2008) ‘Voluntary running exercise alters microbiota composition and increases n-butyrate concentration in the rat cecum’. Biosci Biotechnol Biochem 72, 572576.CrossRefGoogle Scholar
Peake, JM (2002) Exercise-induced alterations in neutrophil degranulation and respiratory burst activity: possible mechanisms of action. Exerc Immunol Rev 8, 49100.Google ScholarPubMed
Jones, AW & Davison, G (2019) Exercise, Immunity, and Illness. Muscle Exercise Physiology, 317344. doi:10.1016/B978-0-12-814593-7.00015-3 Google Scholar
Dimitrov, S, Lange, T, Gouttefangeas, C, et al. (2019) Gαs-coupled receptor signaling and sleep regulate integrin activation of human antigen-specific T cells. J Exp Med 216, 517526.CrossRefGoogle ScholarPubMed
Smith, RP, Easson, C, Lyle, SM, et al. (2019) Gut microbiome diversity is associated with sleep physiology in humans. PLoS One 14, e0222394.CrossRefGoogle ScholarPubMed
Benedict, C, Vogel, H, Jonas, W, et al. (2016) Gut microbiota and glucometabolic alterations in response to recurrent partial sleep deprivation in normal-weight young individuals. J Mol Metab 5, 11751186.CrossRefGoogle ScholarPubMed
Willing, BP, Russell, SL & Finlay, BB (2011) Shifting the balance: antibiotic effects on host-microbiota mutualism. Nat Rev Microbiol 9, 233243.CrossRefGoogle ScholarPubMed
Becattini, S, Taur, Y & Pamer, EG (2016) Antibiotic-induced changes in the intestinal microbiota and disease. Trends Mol Med 22, 458478.CrossRefGoogle ScholarPubMed
Robak, OH, Heimesaat, MM, Kruglov, AA, et al. (2018) Antibiotic treatment-induced secondary IgA deficiency enhances susceptibility to Pseudomonas aeruginosa pneumonia. J Clin Invest 128, 35353545.CrossRefGoogle ScholarPubMed
Tlaskova-Hogenova, H, Stepankova, R, Hudcovic, T, et al. (2004) ‘Commensal bacteria (normal microflora), mucosal immunity and chronic inflammatory and autoimmune diseases’. Immunol Lett 93, 97108.CrossRefGoogle Scholar
Salari, P, Nikfar, S & Abdollahi, M (2012) A meta-analysis and systematic review on the effect of probiotics in acute diarrhea. Inflamm Allergy Drug Targets 11, 314.CrossRefGoogle ScholarPubMed
Luoto, R, Ruuskanen, O, Waris, M, et al (2014) Prebiotic and probiotic supplementation prevents rhinovirus infections in preterm infants: a randomized placebo-controlled trial. J Allergy Clin Immunol 133, 405413.CrossRefGoogle ScholarPubMed
Jespersen, L, Tranow, I, Eskesen, D, et al. (2015) Effect of Lactobacillus. paracasei, L. casei 431 on immune response to influenza vaccination and upper respiratory tract infections in healthy adult volunteers: a randomized, double-blind, placebo-controlled, parallel-group study. Am J Clin Nutr 101, 11881196.CrossRefGoogle ScholarPubMed
Sanders, ME, Akkermans, LM, Haller, D, et al. (2010) Safety assessment of probiotics for human use. Gut Microbes 1, 164185.CrossRefGoogle ScholarPubMed
Mackay, AD, Taylor, MB, Kibbler, CC, et al. (1999) Lactobacillus endocarditis caused by a probiotic organism. Clin Microbiol Infect 5, 290292.CrossRefGoogle ScholarPubMed
Presterl, E, Kneifel, W, Mayer, HK, et al. (2001) Endocarditis by Lactobacillus rhamnosus due to yogurt ingestion? J Infect Dis 33, 710714.Google ScholarPubMed
Ku, W (2006) Probiotics provoked D-lactic acidosis in short bowel syndrome: case report and literature review. HK J Paediatr 11, 246254.Google Scholar
Drakes, M, Blanchard, T & Czinn, S (2004) Bacterial probiotic modulation of dendritic cells. Infect Immun 72, 32993309.CrossRefGoogle ScholarPubMed
Lin, CF, Fung, ZF, Wu, CL, et al. (1996) Molecular characterization of a plasmid- borne (pTC82) chloramphenicol resistance determinant (cat-TC) from Lactobacillus reuteri G4. Plasmid 36, 116124.CrossRefGoogle ScholarPubMed
Shah, NP (2007) Functional cultures and health benefits. Int Dairy J 17, 12621277.CrossRefGoogle Scholar
Bakirci, I (2001) A study on the occurrence of aflatoxin M1 in milk and milk products produced in Van province of Turkey. Food Control 12, 4751.CrossRefGoogle Scholar
Kabak, B & Var, I (2008) Factors affecting the removal of aflatoxin M1 from food model by Lactobacillus and Bifidobacterium strains. J Environ Sci Health Part B Pesticides 43, 617624.CrossRefGoogle ScholarPubMed
Montaseri, H, Arjmandtalab, S, Dehghanzadeh, G, et al (2014) Effect of production and storage of probiotic yogurt on aflatoxin M1 residue. J Food Qual Hazards Control 1, 714.Google Scholar
Zakaria, AM, Amin, YA, Khalil, OSF, et al (2019) Rapid detection of aflatoxin M1 residues in market milk in Aswan Province, Egypt and effect of probiotics on its residues concentration. J Adv Vet Anim Res 6, 197201.CrossRefGoogle ScholarPubMed
Lourens-Hattingh, A & Viljoen, BC (2001) Yoghurt as probiotic carrier food. Int Dairy J 11, 117.CrossRefGoogle Scholar
Williams, NT (2010) ‘Probiotics’. Am J Health-System Pharm 67, 449458.CrossRefGoogle Scholar

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Beyond probiotic legend: ESSAP gut microbiota health score to delineate SARS-COV-2 infection severity
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Beyond probiotic legend: ESSAP gut microbiota health score to delineate SARS-COV-2 infection severity
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Beyond probiotic legend: ESSAP gut microbiota health score to delineate SARS-COV-2 infection severity
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *