Author: Balmant, Bianca D.; Torrinhas, Raquel S.; Rocha, Ilanna M.; Fonseca, Danielle C.; Formiga, Francisco F.C.; Bonfá, Eloisa S.D.O.; Borba, Eduardo F.; Waitzberg, Dan L.
Title: SARS-CoV-2 infection, gut dysbiosis and heterogeneous clinical results of hydroxychloroquine on COVID-19 therapy – Is there a link? Cord-id: 7isjcasa Document date: 2020_12_14
ID: 7isjcasa
Snippet: • Growing evidence suggest a link between gut dysbiosis and poor COVID-19 outcomes; • Impact on gut microbiota seems relevant to select candidate drugs for COVID-19 treatment; • Candidate drugs include hidroxychloroquine (HCQ), but available clinical data question its efficacy/safety; • HCQ efficacy/safety may be influenced by the dose provided and its impact on gut dysbiosis; • This suggestion is based on preliminary findings in systemic lupus erythematosus patients. Clinical manifest
Document: • Growing evidence suggest a link between gut dysbiosis and poor COVID-19 outcomes; • Impact on gut microbiota seems relevant to select candidate drugs for COVID-19 treatment; • Candidate drugs include hidroxychloroquine (HCQ), but available clinical data question its efficacy/safety; • HCQ efficacy/safety may be influenced by the dose provided and its impact on gut dysbiosis; • This suggestion is based on preliminary findings in systemic lupus erythematosus patients. Clinical manifestations of the new severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection can include gastrointestinal signals and symptoms. Individuals with previous clinical conditions that usually enroll gut dysbiosis have been identified at a high-risk to develop more severe infectious phenotypes. Actually, intestinal dysbiosis was observed in infected patients and potentially linked to systemic hyperinflammation. These observations suggest that a previous gut dysbiosis may be aggravated by the SARS-CoV-2 infection and related to the coronavirus disease-19 (COVID-19) progression into more severe stages. While the COVID-19’s pathophysiology is not fully understood it seems relevant to consider the interactions of candidate therapeutic drugs with host, gut microbiota, and SARS-CoV-2. Here we summarize scientific evidence supporting the potential relevance of these interactions and suggest that disputing clinical data on hydroxychloroquine (HCQ) administration in COVID-19 may have been influenced by the dose provided and its impact on gut dysbiosis. The proposition is based on preliminary data of gut microbiota composition in patients with inactive systemic lupus erythematosus under exclusive continuous HCQ treatment, displaying a direct correlation between the drug doses and markers typically associated with gut dysbiosis.
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