The faecal metabolome in COVID-19 patients is altered and associated with clinical features and gut microbes, Lv et al, 2021

[Andy]

Abstract
Although SARS-CoV-2 can invade the intestine, though its effect on digestion and absorption is not fully understood. In the present study, 56 COVID-19 patients and 47 age- and sex-matched healthy subjects were divided into a discovery cohort and a validation cohort. Blood, faeces and clinical information were collected from the patients in the hospital and at discharge. The faecal metabolome was analysed using gas chromatography-mass spectrometry, and Spearman’s correlation analyses of clinical features, the serum metabolome, and the faecal micro- and mycobiota were conducted.

The results showed that, the faeces of COVID-19 patients were enriched with important nutrients that should be metabolized or absorbed, such as sucrose and 2-palmitoyl-glycerol; diet-related components that cannot be synthesized by humans, such as 1,5-anhydroglucitol and D-pinitol; and harmful metabolites, such as oxalate, were also detected. In contrast, purine metabolites such as deoxyinosine and hypoxanthine, low-water-soluble long-chain fatty alcohols/acids such as behenic acid, compounds rarely occurring in nature such as D-allose and D-arabinose, and microbe-related compounds such as 2,4-di-tert-butylphenol were depleted in the faeces of COVID-19 patients. Moreover, these metabolites significantly correlated with altered serum metabolites such as oxalate and gut microbes including Ruminococcaceae, Actinomyces, Sphingomonas and Aspergillus. Although levels of several faecal metabolites, such as sucrose, 1,5-anhydroglucitol and D-pinitol, of discharged patients were not different from those of healthy controls (HCs), those of oxalate and 2-palmitoyl-glycerol did differ. Therefore, alterations in the faecal metabolome of COVID-19 patients may reflect malnutrition and intestinal inflammation and warrant greater attention. The results of present study provide new insights into the pathogenesis and treatment of COVID-19.

Open access, https://www.sciencedirect.com/science/article/pii/S0003267021000933

 

[arewenearlythereyet]

I’ve not read this but the abstract looks to be stating the bleeding obvious ....when people get sick their digestive system is thrown out of balance?

so...how can they make any meaningful observation? How does this compare to any other infection I wonder ...it doesn’t follow this is a direct effect of the particular microbe. Isn’t it more likely that it’s a downstream effect of the bodies response to having an infection of any sort?

I guess there are more obvious signs of COVID severity than taking a poo sample and waiting for it to be analysed so this feels a bit academic.

it would have been infinitely more sensible to have a sick control as well as a healthy one.

 

[Invisible Woman]

it would have been infinitely more sensible to have a sick control as well as a healthy one.

Or even to track individuals over a span of decades. What their gut is like when healthy & in their 20s compared to as they age.

What happens when they get sick with covid or some other infection? If the gut flora & absorption is affected in what way and how long before it returns to it's previous state? Does it return to it's previous state?

And so on.

 

[Subtropical Island]

Sure but expensive and difficult (long term monitoring ...although that should be increasingly doable with many people’s willingness to be monitored 24/7 on health aspects without privacy. I wonder how soon studies will be scaled up dramatically in this sort of way...or if there’s something about the need for rigour that stops that)

My first thought was: they’re in hospital, eating hospital food. Are the controls also staying in the same hospitals? After all, what comes out needs to have gone in in the first place?

And they’re sick (are their stools different from the controls in an obvious way already - eg diarrhoea?). Absorption is very much tied to speed of transit, inflammation etc.

 

[Creekside]

Someone should do some studies of microbiomes of patients with broken bones, gunshot wounds, or other such trauma. Will they find changes in the microbiome? I expect they will. Eventually, they can come up with some methods for determining when microbiome changes are actually caused by a specific disease, and when it just indicates changes in diet, stress, activity, etc.

 

[Invisible Woman]

Sure but expensive and difficult (long term monitoring ...although that should be increasingly doable with many people’s willingness to be monitored 24/7 on health aspects without privacy. I wonder how soon studies will be scaled up dramatically in this sort of way...or if there’s something about the need for rigour that stops that)

Actually this kind of thing was done in the past, I believe. As part of general public health.

In the past of course our information wasn't seen as a commodity with cash value.

if it's possible to anonymise data from any other health study, there's no reason why it couldn't be done for something like this.

Yes, it may be seen as costly but comparing someone else's gut in good health with mine when I'm in poor health isn't necessarily telling you what you might think it's telling you.

Another example if this type of thing is autothyroiditis. Many people face running battles because they don't feel their dose of levothyroxine is adequate. If their blood results are in the normal range then doctors often won't listen. The normal range is very wide though and there's no way of knowing what was normal for the individual once they become sick.