Dysbiosis: An Indicator of COVID-19 Severity in Critically Ill Patients
Abstract
:1. Introduction
2. Results
2.1. Patients’ Characteristics
2.2. Sample Processing
2.3. Alteration of the Gut Bacterial Microbiome of ICU Patients before Their ICU Stay
2.4. Progressive Changes in the ICU Gut and Respiratory Bacterial Microbiomes over Time
2.5. Association between the Bacterial Microbiome and Patients’ Characteristics
2.6. Dysbiosis Score and Association with Disease Severity
2.7. Gut and Respiratory Fungal Microbiome
3. Discussion
4. Methods and Materials
4.1. Study Design
4.2. Sample Collection
4.3. Microbial DNA Extraction
4.4. Microbiome Composition Analysis
4.5. Microbiome Load Analysis
4.6. Plasma Immunoglobulin and Cytokine Measurements
4.7. Statistical Analysis
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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Column1 | HC | ICU-COV(−) | ICU COV(+) | Statistics |
---|---|---|---|---|
Baseline demographic characteristics | n = 17 | n = 32 | n = 46 | |
Age (median, years) | 55 | 58 | 61 | p = 0.12 (Kruskal–Wallis) |
Female (%) | 9 (52.3%) | 12 (37.5%) | 14 (30%) | p = 0.25 (Chi-square) |
Body mass index (kg/m2) > 30 | 1 (5.9%) | 7 (21.8%) | 18 (39.1%) | p = 0.02 (Chi-square) |
Comorbidities and other underlined conditions | ||||
Arterial hypertension | ND | 12 (37.5%) | 25 (54.3%) | p = 0.17 (Fisher’s) |
Chronic obstructive pulmonary disease (COPD) | ND | 1 (3.1%) | 12 (26%) | p = 0.01 (Fisher’s) |
Diabetes mellitus (type 2) | ND | 18 (56.2%) | 16 (34.8%) | p = 0.068 (Fisher’s) |
Immunosuppression | ND | 0 | 12 (26%) | p = 0.0010 (Fisher’s) |
Index/Scores | ||||
Acute respiratory distress syndrome (ARDS) | ND | ND | 35 (76%) | |
PaO2/FiO2 < 150 | ND | ND | 31 (67.4%) | |
Therapies | ND | |||
Anticoagulant prophylaxis | ND | 32 (100%) | 46 (100%) | |
Dexamethasone | ND | 0 | 46 (100%) | |
Neuromuscular-blocking drug | ND | 12 (19.3%) | 40 (86.9%) | p < 0.0001 (Fisher’s) |
Orotracheal intubation | ND | 32 (100%) | 46 (100%) | |
Prone position | ND | 6 (18.7%) | 34 (73.9%) | p < 0.0001 (Fisher’s) |
Remdesivir | ND | 0 | 2 (4.3%) | p = 0.5 (Fisher’s) |
Tocilizumab | ND | 0 | 9 (19.5%) | p = 0.0088 (Fisher’s) |
Tracheotomy | ND | 13 (40.6%) | 12 (26%) | p = 0.61 (Fisher’s) |
Therapy pre-ICU | ||||
Pre-ICU antibiotics, mean days (SD) | 0 | 0.7 (1.18) | 1 (1.7) | p = 0.61 (Mann–Whitney) |
Pre-ICU corticosteroids, mean days (SD) | 0 | 0.1 (0.5) | 2.1 (2.1) | p < 0.0001 (Mann–Whitney) |
Timing | ||||
Total length of hospitalization, mean days (SD) | ND | 30.91 | 31.09 | p = 0.32 (Mann–Whitney) |
Length of ICU stay, mean days (SD) | ND | 20.63 | 21.91 | p = 0.43 (Mann–Whitney) |
Pre-ICU length of hospital stay, mean days (SD) | 0 | 0.5 (0.96) | 9.7 (3.3) | p < 0.0001 (Mann–Whitney) |
Pre-ICU symptoms, mean days (SD) | 0 | 2.35 (4) | 3 (2.5) | p < 0.0001 (Mann–Whitney) |
Laboratory data at admission | ||||
C-reactive protein (CRP) (mg/dL) | ND | 19.1 | 9.6 | p = 0.03 (Mann–Whitney) |
D-Dimer (ng/mL) | ND | ND | 4825 | |
Ferritin (ng/mL) | ND | ND | 1195 | |
Lactate Dehydrogenase (LDH) (U/L) | ND | ND | 459 | |
Leukopenia (10*3/mcL) | ND | ND | 12 | |
Troponin (pg/mL) | ND | ND | 13.66 |
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Cuenca, S.; Soler, Z.; Serrano-Gómez, G.; Xie, Z.; Barquinero, J.; Roca, J.; Sirvent, J.-M.; Manichanh, C. Dysbiosis: An Indicator of COVID-19 Severity in Critically Ill Patients. Int. J. Mol. Sci. 2022, 23, 15808. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms232415808
Cuenca S, Soler Z, Serrano-Gómez G, Xie Z, Barquinero J, Roca J, Sirvent J-M, Manichanh C. Dysbiosis: An Indicator of COVID-19 Severity in Critically Ill Patients. International Journal of Molecular Sciences. 2022; 23(24):15808. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms232415808
Chicago/Turabian StyleCuenca, Silvia, Zaida Soler, Gerard Serrano-Gómez, Zixuan Xie, Jordi Barquinero, Joaquim Roca, Jose-Maria Sirvent, and Chaysavanh Manichanh. 2022. "Dysbiosis: An Indicator of COVID-19 Severity in Critically Ill Patients" International Journal of Molecular Sciences 23, no. 24: 15808. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms232415808