Immunodepletion with Hypoxemia: A Potential High Risk Subtype of Coronavirus Disease 2019

Lilei Yu; Yongqing Tong; Gaigai Shen; Aisi Fu; Yanqiu Lai; Xiaoya Zhou; Yuan Yuan; Yuhong Wang; Yuchen Pan; Zhiyao Yu; Yan Li; Tiangang Liu; Hong Jiang

The copyright holder for this preprint (which was not peer-reviewed) is . https://doi.org/10.1101/2020.03.03.20030650 doi: medRxiv preprint microbiota, and gut microbiota homeostasis is modulated by the immune system 12 . It was shown that a variety of immune factors was capable of altering gut microbiota homeostasis balance, such as IL-10, IL-23, NLRP6, NOD-like receptor protein 3, and IgA 13 . And the imbalance or dysbiosis in gut microbiota would contribute to an enhanced mucosal permeability and thus leading to microbial translocation and a second infection. Moreover, gut microbiota was able to modulate the immune response and played an important role in immune-mediated diseases, suggesting a vicious circle between immune disorder and gut microbiota imbalance 14 . All these findings indicated that the balance of gut microbiota can be disrupted in case of coronavirus infection due to the immune disorder. In this study, we further identified the changes in gut microbiota during the novel coronavirus infection and found that (1) the proportion of probiotics was significantly reduced, such as Bifidobacterium, Lactobacillus, and Eubacterium, and (2) the proportion of conditioned pathogenic bacteria was significantly increased, such as Corynebacterium of Actinobacteria and Ruthenibacterium of Firmicutes. In addition, we also found that the fungi in the gut microbiota of the two patients are not common fungi in healthy cohort (eg. Candida and Saccharomyces cerevisiae), some rare fungi dominate the fungal of gut microbiota, such as Aspergillus, Kluyveromyces.