肠道优势菌群丰度变化与新冠病毒肺炎严重程度相关性的临床意义

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新冠病毒肺炎(COVID-19)是一种高度传染性疾病.与H7N9感染相似,COVID-19的典型临床表现是肺炎和细胞因子风暴.我们在既往研究中观察到H7N9患者存在肠道菌群失调.然而,肠道微生物菌群与COVID-19之间的关系尚未明确.本研究共纳入了57名COVID-19患者,其中包括20例普通型、19例重型以及18例危重型.本研究的目的是利用定量聚合酶链反应(q-PCR),研究COVID-19患者的10种主要肠道优势菌群的丰度变化,从而建立这些菌群与COVID-19临床指标之间的相关性.结果表明,COVID-19患者的10种主要肠道菌群丰度出现变化,这些肠道微生物菌群的变化与疾病严重程度和血液学指标有关.产丁酸菌,如普拉梭菌(Faecalibacterium prausnitzii)、酪酸梭菌(Clostridium butyricum)、柔嫩梭菌(Clostridium leptum)、直肠真杆菌(Eubacterium rectale)的丰度显著降低,细菌群落的这些变化有助于区分危重型与普通型和重型患者.此外,常见的条件致病菌肠球菌(Enterococcus,Ec)和肠杆菌科细菌(Enterobacteriaceae,E)的丰度在COVID-19患者中增加,尤其对于预后较差的危重型患者.这些结果表明,这些肠道优势菌群可作为COVID-19的诊断生物标志物,并且Ec/E值可用于预测危重型患者预后.“,”Coronavirus disease 2019 (COVID-19) is a highly contagious infectious disease. Similar to H7N9 infection, pneumonia and cytokine storm are typical clinical manifestations of COVID-19. Our previous studies found that H7N9 patients had intestinal dysbiosis. However, the relationship between the gut micro-biome and COVID-19 has not been determined. This study recruited a cohort of 57 patients with either general (n=20), severe (n=19), or critical (n=18) disease. The objective of this study was to investigate changes in the abundance of ten predominant intestinal bacterial groups in COVID-19 patients using quantitative polymerase chain reaction (q-PCR), and to establish a correlation between these bacterial groups and clinical indicators of pneumonia in these patients. The results indicated that dysbiosis occurred in COVID-19 patients and changes in the gut microbial community were associated with disease severity and hematological parameters. The abundance of butyrate-producing bacteria, such as Faecalibacterium prausnitzii, Clostridium butyricum, Clostridium leptum, and Eubacterium rectale, decreased significantly, and this shift in bacterial community may help discriminate critical patients from general and severe patients. Moreover, the number of common opportunistic pathogens Enterococcus (Ec) and Enterobacteriaceae (E) increased, especially in critically ill patients with poor prognosis. The results sug-gest that these bacterial groups can serve as diagnostic biomarkers for COVID-19, and that the Ec/E ratio can be used to predict death in critically ill patients.
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