Fig. 3.

Dynamic change of DMM clusters in three body sites of COVID-19 children. The community type levels were divergent between respiratory tract and gut (e.g., on Days 11, 15, and 23 in CV04, and Days 16 and 42 in CV09). The respiratory microbiome appeared to be progressively worsening in 7 children (CV01–CV04 and CV07–CV09) for 25–42 days after symptom onset. The worsening of the gut microbiome appeared in 4 children (CV03, CV04, CV07, and CV09) and sustained for 25–52 days. Age (months) of each COVID-19 child is shown in parenthesis below the patient code. Eight DMM clusters (community types) are shown with circles of different colors. Small, medium, and large circles represent the body sites of throat, nasopharynx, and feces, respectively. The discharge date of each COVID-19 child is highlighted by vertical yellow thick line. The status of SARS-CoV-2 RNA in each sample is shown in corresponding circle with “+” for positive and “−” for negative. The arrows indicate an increase of the alpha diversity of bacterial community type.