Probiotics and COVID-19: Hong Kong researchers trialling formula in COVID-19 patients, high-risk and general population
The probiotic formula was derived from a recent study by CUHK which found that COVID-19 patients were lacking a series of good bacteria, instead hosting a range of bad bacteria in their guts.
Published in the Gastroenterology journal, researchers said patients had higher levels of Clostridium hathewayi, Bacteroides nordii, and Actinomyces viscosus compared to the healthy population.
On the other hand, good bacteria such as Fecalibacterium prausnitzii, Lachnospiraceae bacterium 5_1_63FAA, Eubacterium rectale, Ruminococcus obeum, and Dorea formicigeneran were depleted in these patients.
One of the authors, Professor Siew Chien Ng, who is also associate director of the Centre for Gut Microbiota Research at CUHK said the gut microbiota contains trillions of bacteria and are in equilibrium in healthy people. The gut microbiota regulates the immune system, and an imbalance (dysbiosis) would result in lower immunity and higher susceptibility to infections.
From February to March, researchers collected faecal samples from COVID-19 patients upon hospitalisation until discharged and compared them with those from healthy individuals.
Professor Ng said there were 23 types of unfavourable bacteria found in COVID-19 patients and explained that the more unfavourable bacteria found in patients, the more severe their symptoms were.
“Striking findings from our research showed that after patients have cleared the virus, even up to 30 days, they still have abnormal gut bacterial profile in their stool which may have disturbance in regard to health and it could still put them at high risk of having future infections.”
Probiotic formula
Professor Ng told NutraIngredients-Asia: “We developed the (probiotic) formula based on what we understand is missing from COVID-19 patients, and what we know is present in healthy people.”
She said they used 1500 healthy Chinese (Hong Kong and China) gut bacteria profile as a reference and have increased the initial 15 COVID-19 patients to 150 now.
Using big data analysis and machine learning, the research team developed a probiotic formula that aims to target gut dysbiosis.
The plan now is to test its probiotic formula in three studies.
The first study will involve 200 COVID-19 patients who will be given this formula for three months, and undergo a follow-up period for six months where their stool bacteria profile will be collected.
The second study is a randomised controlled trial for 150 high-risk people and 150 non-high risk people (placebo). High-risk people are healthcare professionals, carers, people travelling abroad especially to COVID-19 hotspots, elderly as well as people with underlying health conditions including CVD, obesity, and type 2 diabetes.
The third study involves 500 people in the general population. All three studies are currently recruiting participants.
As the studies are mainly conducted on a Chinese population, Professor Ng said this probiotic formula is specifically targeted to the Asian Chinese as “microbiota differs according to ethnicity, geography, diet, and environment.”
The formula is in the midst of applying for a patent in China and US, and while researchers were unable to share the strains included in the formula, Professor Ng said it will contain several strains that were stable and missing from these patients.
The researchers have conducted stability tests to ensure the strains can resist gastric acid. In addition, Professor Ng said their formula will contain more than the standard CFU requirement.
“The world probiotic dataset stipulates that products should have at least 10^6 or 10^7 in order to maintain the health benefits. Our product will contain more than that, at least 100 times more in CFU.”
Professor Ng said they were currently working with supplement and food companies to develop its formula into respective formats that were easily consumed by the general population. Some of these include yoghurt, health drinks and supplement sachets.
Formula going forward
Early in January 2020, the National Health Commission (NHC) of the People's Republic of China had set out a set of recommendations to the public and medical community when COVID-19 first peaked in the country.
Among the recommendations include the use of probiotics for the prevention of secondary bacterial infections in COVID-19 patients. However, there were no evidence to support the recommendation, until now.
Professor Ng said her team’s findings were the first in the world to assess the imbalance of bacteria in COVID-19 patients, and associated it to the severity of the disease.
“In some ways, our findings may be the first to support the recommendations by NHC, and may be a reasonable approach to target people who really need it. We still need more research and data to support how we move forward.”
Professor Ng said the team hopes its probiotic formula is not only limited for COVID-19, “We want to expand our pipeline, and eventually target other emerging infectious diseases such as influenza.”
Source: Gastroenterology
https://doi.org/10.1053/j.gastro.2020.05.048
“Alterations in Gut Microbiota of Patients With COVID-19 During Time of Hospitalization”
Authors: Tao Zuo, et al.
