Alterations of the Gut Microbiota in Patients with COVID-19 or H1N1 Influenza

Gu, Silan; Chen, Yanfei; Wu, Zhengjie; Chen, Yunbo; Gao, Hainv; Lv, Longxian; Guo, Feifei; Zhang, Xuewu; Luo, Rui; Huang, Chenjie; Lu, Haifeng; Zheng, Beiwen; Zhang, Jiaying; Yan, Ren; Zhang, Hua; Jiang, Huiyong; Xu, Qiaomai; Guo, Jing; Gong, Yiwen; Tang, Lingling; Li, Lanjuan

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging serious global health problem. Gastrointestinal symptoms are common in COVID-19 patients, and SARS-CoV-2 RNA has been detected in stool specimens. However, the relationship between the gut microbiome and disease remains to be established. METHODS: We conducted a cross-sectional study of 30 COVID-19 patients, 24 influenza A (H1N1) patients, and 30 matched healthy controls (HC) to identify differences in the gut microbiota by 16S ribosomal RNA (rRNA) gene V3-V4 region sequencing. RESULTS: Compared with HC, COVID-19 patients had significantly reduced bacterial diversity, a significantly higher relative abundance of opportunistic pathogens, such as Streptococcus, Rothia, Veillonella and Actinomyces, and a lower relative abundance of beneficial symbionts. Five biomarkers showed high accuracy for distinguishing COVID-19 patients from HC with an area under the curve (AUC) up to 0.89. Patients with H1N1 displayed lower diversity and different overall microbial composition compared with COVID-19 patients. Seven biomarkers were selected to distinguish the two cohorts with an AUC of 0.94. CONCLUSION: The gut microbial signature of patients with COVID-19 was different from that of H1N1 patients and HC. Our study suggests the potential value of the gut microbiota as a diagnostic biomarker and therapeutic target for COVID-19, but further validation is needed.