TABLE 3.
Oral Bacteriotherapy and Fecal Microbiota Transplantation (FMT) in Patients With COVID-19
| References | Region, Country | Subjects/Patients (n) | Intervention (n) | Aims | Main Findings |
|---|---|---|---|---|---|
| Oral bacteriotherapy for COVID-19 | |||||
| Ceccarelli et al40 | Lazio, Italy | COVID-19 (200) with severe pneumonia | BAT (112), BAT+Sivommixx (88) | Retrospective analysis of mortality rates | Lower mortality rates with combined therapy vs. BAT alone (11% vs. 30%) Increased mortality factors: age >65, CRP> 41.8 mg/L, platelets <150.000/mmc Oral bacteriotherapy was an independent factor for lower mortality |
| d’Ettorre et al41 | Rome, Italy | COVID-19 (70) | Hydroxicloroquine, and/or antibiotics, and/or Tocilizumab (42) Same + Sivommixx (28) | Oral bacteriotherapy as complementary therapeutic strategy to avoid the progression of COVID-19 | Bacteriotherapy induced remission of diarrhea fever, asthenia, headache, myalgia, and dyspnea in all patients vs. half of the not supplemented group |
| FMT for CDI during the COVID-19 pandemic | |||||
| Liu et al16 | Ganzhou City, China | COVID-19 1 mo after being discharged from the hospital (11); GI symptoms: constipation, diarrhea, abdominal pain, gastralgia, acid reflux, gastrectasia (5/11) | FMT by 10 oral capsules/day×4 consecutive days | Investigate the potential benefit over GI symptoms | GI symptoms improved after FMT Altered peripheral lymphocytes: Decreased naive B cells (P=0.012); Increased memory B cells (P=0.001); Increased nonswitched B cells (P=0.012) FMT partially restored gut dysbiosis by increasing the relative abundance of phylum Actinobacteria (15.0%), reduced Proteobacteria (2.8%); increased genera Bifidobacterium and Faecalibacterium |
| Ianiro et al42 | Rome, Italy | Recurrent or refractory CDI (21) | FMT for CDI during the COVID-19 pandemic | To report outcomes of a FMT service that adapted its operational workflow to prevent SARS-CoV-2 transmission | No recurrence of CDI after FMT in 18 that were followed for 8 wk It was possible to maintain standard volumes, efficacy and safety of FMT for CDI during the COVID-19 pandemic |
| Olesen et al43 | Cambridge Massachusetts, USA | Abstract model of FMT donors, simulating their donation schedule, SARS-CoV-2 infection incidence, and COVID-19 disease course | Estimate the utility of different testing strategies (PCR with nasopharyngeal swabs, stool-based PCR, donor serology tests, or a combination of those assays | Mathematical model to determine the effectiveness of the testing strategies | The risk that a released donation is virus-positive varied approx. proportionally with the incidence of infection: a 10-fold increase in incidence led to 10-fold increased risk The more stringent testing strategies (symptoms checks, nasopharyngeal swabs, serology tests, testing every stool) the lower the probability of releasing a virus-positive stool for donation |
BAT indicates best available therapy (low–molecular-weight heparin plus one or more of hydroxychloroquine, azithromycin, antivirals, and tocilizumab); CDI, clostridium difficile infection; FMT, fecal microbiota transplantation; GI, gastrointestinal; Sivomixx, an oral a multistrain product containing 5 strains of Lactobacilli, 2 strains of Bifidobacteria, and 1 strain of Streptococcus thermophiles.