Efficacy and Safety of Washed Microbiota Transplantation to Treat Patients with Mild-to-Severe COVID-19 and Suspected of Having Gut Microbiota Dysbiosis: Study Protocol for a Randomized Controlled Trial

Li-hao Wu , Zhi-ning Ye , Ping Peng , Wen-rui Xie , Jia-ting Xu , Xue-yuan Zhang , Harry Hua-xiang Xia , Xing-xiang He

Current Medical Science ›› 2021, Vol. 41 ›› Issue (6) : 1087 -1095.

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Current Medical Science ›› 2021, Vol. 41 ›› Issue (6) : 1087 -1095. DOI: 10.1007/s11596-021-2475-2
Article

Efficacy and Safety of Washed Microbiota Transplantation to Treat Patients with Mild-to-Severe COVID-19 and Suspected of Having Gut Microbiota Dysbiosis: Study Protocol for a Randomized Controlled Trial

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Abstract

Objective

Coronavirus disease 2019 (COVID-19) is often accompanied by gastrointestinal symptoms, which are related to gut microbiota dysbiosis (GMD). Whether washed microbiota transplantation (WMT) is an effective treatment for COVID-19 patients suspected of having GMD by restoring the gut microbiota is unknown. This study is designed to explore the efficacy and safety of WMT in COVID-19 patients suspected of having GMD.

Methods

This is a randomized, multicenter, single-blind prospective study. COVID-19 patients suspected of having GMD will be randomly divided to receive routine treatment only or to receive routine treatment and WMT. The frequency of WMT will be once a day for three consecutive days. Laboratory and imaging examinations will be performed at admission, 1 and 2 weeks after treatment, and on the day of discharge. Then a telephone follow-up will be conducted at 1st week, 2nd week, and 6th month after discharge. The clinical efficacy and safety of WMT in COVD-19 patients suspected of having GMD and the effects of WMT on the organ function, homeostasis, inflammatory response, intestinal mucosal barrier function, and immunity of the patients will be evaluated.

Results

By following the proposed protocol, WMT is expected to be efficacious and safe for the treatment of COVID-19 patients suspected of having GMD, and the therapeutic effect is expected to be associated with improvement of the intestinal mucosal barrier function, inflammatory response, and immunity.

Conclusion

The findings from this study may offer a new approach for the prevention and treatment of COVID-19 patients suspected of having GMD.

Keywords

COVID-19 / SARS-Cov-2 virus / gut microbiota / microbiome / dysbiosis / washed microbiota transplantation

Cite this article

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Li-hao Wu, Zhi-ning Ye, Ping Peng, Wen-rui Xie, Jia-ting Xu, Xue-yuan Zhang, Harry Hua-xiang Xia, Xing-xiang He. Efficacy and Safety of Washed Microbiota Transplantation to Treat Patients with Mild-to-Severe COVID-19 and Suspected of Having Gut Microbiota Dysbiosis: Study Protocol for a Randomized Controlled Trial. Current Medical Science, 2021, 41(6): 1087-1095 DOI:10.1007/s11596-021-2475-2

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References

[1]

SunP, LuX, XuC, et al.. Understanding of COVID-19 based on current evidence. J Med Virol, 2020, 92(6): 548-551

[2]

CheungKS, HungIFN, ChanPPY, et al.. Gastrointestinal manifestations of SARS-CoV-2 infection and virus load in fecal samples from a Hong Kong cohort: Systematic review and meta-analysis. Gastroenterology, 2020, 159(1): 81-95

[3]

ZuoT, ZhangF, LuiGCY, et al.. Alterations in gut microbiota of patients with COVID-19 during time of hospitalization. Gastroenterology, 2020, 159(3): 944-955

[4]

YaoWU. Effect of intestinal flora imbalance on acute lung injury in mice infected with influenza virus. Modern Prevent Med (Chinese), 2018, 45(4): 694-699

[5]

TayMZ, PohCM, RéniaL, et al.. The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol, 2020, 20(6): 363-374

[6]

BradleyKC, FinsterbuschK, SchnepfD, et al.. Microbiota-driven tonic interferon signals in lung stromal cells protect from influenza virus infection. Cell Rep, 2019, 28(1): 245-256.e244

[7]

YitbarekA, Taha-AbdelazizK, HodginsDC, et al.. Gut microbiota-mediated protection against influenza virus subtype H9N2 in chickens is associated with modulation of the innate responses. Sci Rep, 2018, 8(1): 13189

[8]

LeePH, TayWC, SutjiptoS, et al.. Associations of viral ribonucleic acid (RNA) shedding patterns with clinical illness and immune responses in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Clin Transl Immunology, 2020, 9(7): e1160

[9]

d’EttorreG, CeccarelliG, MarazzatoM, et al.. Challenges in the management of SARS-CoV2 infection: The role of oral bacteriotherapy as complementary therapeutic strategy to avoid the progression of COVID-19. Front Med (Lausanne), 2020, 7: 389

[10]

ZhangT, LuG, ZhaoZ, et al.. Washed microbiota transplantation vs. manual fecal microbiota transplantation: clinical findings, animal studies and in vitro screening. Protein Cell, 2020, 11(4): 251-266

[11]

Nanjing consensus on methodology of washed microbiota transplantation. Chin Med J (Engl), 2020,133(19):2330–2332

[12]

National Health Commission of the People’s Republic of China. COVID-19 diagnosis and treatment guideline in china, 7th ed. http://www.nhc.gov.cn/yzygj/s7653p/202003/46c9294a7dfe4cef80dc7f5912eb1989.shtml.

[13]

LimWS, van der EerdenMM, LaingR, et al.. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax, 2003, 58(5): 377-382

[14]

KnausWA, DraperEA, WagnerDP, et al.. APACHE II: a severity of disease classification system. Crit Care Med, 1985, 13(10): 818-829

[15]

IaniroG, MullishBH, KellyCR, et al.. Screening of faecal microbiota transplant donors during the COVID-19 outbreak: suggestions for urgent updates from an international expert panel. Lancet Gastroenterol Hepatol, 2020, 5(5): 430-432

[16]

MatsumotoH, ShiotaniA, GrahamDY. Current and future treatment of Helicobacter pylori infections. Adv Exp Med Biol, 2019, 1149: 211-225

[17]

ThursbyE, JugeN. Introduction to the human gut microbiota. Biochem J, 2017, 474(11): 1823-1836

[18]

ChoiHH, ChoYS. Fecal microbiota transplantation: Current applications, effectiveness, and future perspectives. Clin Endosc, 2016, 49(3): 257-265

[19]

LiH, LiuX, ChenF, et al.. Avian influenza virus subtype H9N2 affects intestinal microbiota, barrier structure injury, and inflammatory intestinal disease in the chicken ileum. Viruses, 2018, 10(5): 270

[20]

HanadaS, PirzadehM, CarverKY, et al.. Respiratory viral infection-induced microbiome alterations and secondary bacterial pneumonia. Front Immunol, 2018, 9: 2640

[21]

YildizS, Mazel-SanchezB, KandasamyM, et al.. Influenza A virus infection impacts systemic microbiota dynamics and causes quantitative enteric dysbiosis. Microbiome, 2018, 6(1): 9

[22]

OldstoneMB, RosenH. Cytokine storm plays a direct role in the morbidity and mortality from influenza virus infection and is chemically treatable with a single sphingosine-1-phosphate agonist molecule. Curr Top Microbiol Immunol, 2014, 378: 129-147

[23]

WangS, LeTQ, KuriharaN, et al.. Influenza virus-cytokine-protease cycle in the pathogenesis of vascular hyperpermeability in severe influenza. J Infect Dis, 2010, 202(7): 991-1001

[24]

MarcellaC, CuiB, KellyCR, et al.. Systematic review: the global incidence of faecal microbiota transplantation-related adverse events from 2000 to 2020. Aliment Pharmacol Ther, 2021, 53(1): 33-42

[25]

YeZN, XiaHH, ZhangR, et al.. The efficacy of washed microbiota transplantation on Helicobacter pylori eradication: A pilot study. Gastroenterol Res Pract, 2020, 2020: 8825189

[26]

ZhongHJ, ZengHL, CaiYL, et al.. Washed microbiota transplantation lowers blood pressure in patients with hypertension. Front Cell Infect Microbiol, 2021, 11: 679624

[27]

WangS, XuM, WangW, et al.. Systematic review: Adverse events of fecal microbiota transplantation. PloS one, 2016, 11(8): e0161174

[28]

He XX, Wu LH, Ye ZN, et al. Treatment of COVID-19 patients suspected with gut microbiota dysbiosis with washed microbiota transplantation: study protocol for a randomized controlled trial. Preprint at https://www.researchsquare.com/article/rs-56663/v1 (2020).

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