Long covid, the gut microbiome and healing
By Dr. Rebecca Brook
Acupuncturist, and Dr. of Chinese Medicine
Modifying the gut microbiome may aid recovery from post-acute COVID-19 (PACS), or long COVID, with new research demonstrating a strong association between gut dysbiosis and persistent symptoms in patients with COVID-19 up to six months after virus clearance (1).
With an increasing population of patients recovering from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there is significant interest in understanding and treating the phenomenon of ‘long COVID’ or PACS, a collection of mild to debilitating symptoms that persist weeks to months after initial infection (2).
The exact cause of long COVID is yet to be elucidated; however, possible contributing factors include excessive immune response, ongoing inflammation, cellular damage during acute infection, and physical effects of severe illness (2). In addition, a recent study identified four factors potentially involved in causing long COVID (3):
Type 2 diabetes
Reactivation of Epstein-Barr virus
Presence of specific autoantibodies
Circulating mRNA fragments of SARS-CoV-2 in the blood (RNAaemia).
Previous research has found that individuals who experience severe COVID-19 tend to have gut dysbiosis, characterised by reduced microbiota diversity, increased abundance of opportunistic pathogens, and fewer gut commensals with immunomodulatory effects (4,5,6). Furthermore, gut dysbiosis may persist well after virus clearance and has been linked to disease severity, impaired pulmonary function, and inflammatory reaction in follow-up studies of COVID-19 patients at 3 and 6 months (7).
The current prospective study included 106 patients who had been hospitalised with mild to severe COVID-19 and 68 controls without COVID-19. The participants gave stool samples on admission and at 1 month and 6 months after discharge from hospital. Shotgun metagenomic sequencing was used to analyse microbiota from 258 stool samples, and the results correlated with symptoms at 6 months.
Following their discharge from the hospital, 81% of people still had at least one lingering symptom 3 months later. After 6 months, 76% still had at least one symptom, with fatigue (31.3%), poor memory (28.3%), hair loss (21.7%), anxiety (20.8%) and difficulty in sleeping (20.8%) being the most common symptoms.
Restoring the gut microbiome
The association between a persistently altered gut microbiome and long-term sequelae of COVID-19, together with emerging evidence from small clinical trials with probiotics in patients with long COVID, suggests that there is an opportunity to ameliorate these long-lasting symptoms by regulating the gut microbiome.
In a recent experimental study, supplementation with a lactobacillus probiotic blend and inulin for 30 days significantly improved gastrointestinal symptoms, cough, fatigue, and subjective wellbeing scores in patients with long COVID (average symptom length of 120 days) (11)
The best approach in going to be unique to each person.
But the best approach means seeking appropriate, professional advice through a registered practitioner. Dr. Rebecca Brook is available for consultations at Beach Acupuncture, Christies Beach to discuss your long-covid needs. Even if you haven’t had an “official” diagnosis, you may find you fall into this category anyway!
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