COVID-19 and Probiotics: A (Successful) Clinical Study

With the COVID crisis continuing to rage on, I have been keeping an eye out for anything we can all do now.  Last week I wrote a post about the potential protective mechanisms afforded by helminths.   Today I’m covering a recent clinical trial using probiotics to treat patients with severe COVID.[i]

The trial involved 70 hospitalized patients with confirmed COVID-19.  Most had fevers, needed non-invasive oxygen treatments (i.e. needed oxygen but were not intubated), and had more than 50% lung involvement confirmed by CT scan.  Many also had GI symptoms – mainly diarrhea.  The authors point out that even in acute COVID, according to some research, only 10% of people show coronavirus DNA in blood, but almost 50% show the DNA in stool, and transmission via stool is possible.  One Chinese study also showed differences in the bacterial microbiomes of those who died from COVID:  they had significantly lower levels of Bidfidobacteria and Lactobacilli (two of the main kinds of symbiotic bacteria in people) as well as an increase in pathogenic bacteria.

28 of the subjects in the study received a probiotic (more on that in a moment) while 42 did not.  Other than the probiotic, all were treated with the same medicine regimen.  The results are  astounding:

1. All the patients who received the probiotic had diarrhea resolve completely within 7 days, although many had the diarrhea resolve completely within 24 hours and most, within 3 days.  Their other symptoms also began to resolve more quickly – by the 2^nd day of treatment.
2. In contrast, less than half the patients who did not receive the probiotics had their diarrhea resolve within 7 days!
3. The researchers “…observed a significant difference” in respiratory outcomes between the two groups. After 7 days of treatment, there was an 8-fold decreased risk to evolve to respiratory failure.
4. All the patients treated with probiotic survived COVID and none required ventilators, as opposed to the untreated group which had patients transferred to the ICU and/or die at rates in line with what Italy was experiencing at the time of the trial (late March-early April): “Results evidenced a worse survival, as well as, a higher risk of transfer to an intensive resuscitation for the patient not supplemented with bacteriotherapy respective to the supplemented one.”

They hypothesize that the reason for the incredible success of probiotics against the virus has to do with both the metabolites (like short chain fatty acids) produced by good bacterial flora and that,  “…in patients infected by COVID-19, a bacterial formulation with the ‘appropriate’ biochemical and immunological profile might trigger several protective biological functions.”

They chose the formulation they used in the trial specifically for its specific anti-viral properties.  The product is produced by a Swiss company and is called Sivomixx,  which comes in sachets of 200 billion organisms.  These patients were given a total of 2.4 TRILLION organisms, broken up into 3 equal doses throughout the day.  (Remember how, so many times, I’ve pointed out to you the incredibly low doses of probiotics often used in trials (I mentioned this just this week – on Tuesday, in fact, in my last post about ALS…)

The conclusion of this paper:  “Oral bacteriotherapy has shown a statically significant impact on the clinical conditions of COVID-19 patients.”

Two more things to point out to you:  just a couple of weeks ago in this post I pointed out to you that in a 2005 clinical trial, after 7 days (not a coincidence, I’m sure) of giving probiotics to patients on ventilators the patients showed a reduction of all inflammatory markers, had shorter stays in the ICU and fewer days on the ventilators.  They also had less antibiotic associated diarrhea and other GI symptoms.

I also wanted to point out that in December of 2017, I wrote a post on using probiotics to avoid the flu.  The researchers in that study found that treating mice with lactic acid producing probiotics (especially a strain of Lactobacillus casei) developed protective immunity to influenza.  In another study I mentioned in that post, a species of Bifido bacteria also showed efficacy against influenza comparable to the pharmaceutical treatment Tamiflu.

The point is, there seems to be some pretty good evidence that supplementing with probiotics may be a particularly good idea at the moment.

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[i] D’Ettorre, G, et. Al. Challenges in the management of SARS-CoV2 infection: the role of oral bacteriotherapy as complementary therapeutic strategy to avoid the progression of COVID-19.  Frontiers in Medicine. 2020;7(389). https://doi.org/10.3389/fmed.2020.00389