Differences in gut microbiome linked to risk of death in COVID-19 patients with respiratory failure

A new study finds differences in gut bacteria and metabolites among COVID-19 patients admitted to the ICU, offering possibilities for preventing the worst outcomes.

In early 2020, Bhakti Patel, MD, a pulmonary and critical care specialist at the University of Chicago Medicine, and Matthew Stutz, MD, who was a critical care fellow at the time, had an idea for a research project. They wanted to study the gut microbiome of patients admitted to the ICU to see if it could help them understand why some patients recover and do well after discharge from the hospital, and others continue to suffer from debilitating complications. Many of the common interventions that physicians use in the ICU, like sedation, antibiotics, putting people on ventilators, or keeping them immobile for long periods of time, can have unintended consequences and cause lasting injuries, even if they ultimately help the patient recover from the initial injury or illness that brought them to the hospital in the first place.

“We were trying to tie together factors that might lend itself to a biologic explanation of why patients get disabled after surviving an ICU stay that goes beyond just the stuff that we do that could have complications,” said Patel, who is an Assistant Professor of Medicine. But, as with so many other projects conceived during this time, Patel said, “And then COVID hit.”

The pandemic upended everything in health care, especially for pulmonary specialists in the ICU. For her part—amidst caring for the crush of patients—Patel worked on an innovative, helmet-based ventilation system that helps prevent critically ill patients from being put on a ventilator. Meanwhile, she and Stutz, who now works at Stroger Hospital in Chicago, pivoted their project to an opportunity to understand the role of the microbiome in severe COVID-19 infections.

The results of this work, published in Nature Communications in November 2022, show that the composition of gut microbiota and the metabolites they produce can predict the trajectory of respiratory function and death in patients with severe COVID-19. This suggests that the gut microbiome has important links to lung health and presents an opportunity to prevent the worst outcomes.

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Originally published in BSD Features  on 1/9/2023 and written by Matt Wood.