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The Role of the Gut Microbiome in the COVID-19 Pandemic

Hand stopping a virus

We are witnessing COVID-19 affect different people in different ways. The question that has been asked since the beginning of the pandemic is why some patients suffer mild or no symptoms while others experience severe illness. This distinctive hit-and-miss pattern is creating confusion in the research of this novel disease.

The Relationship between Gut Microbiome and COVID-19

A basic understanding of the gut–lung axis and its implications in both health and disease has been established in recent years. The cross-talk between the gut microbiome - the community of trillions of microbes - and lungs seems to be bidirectional [1,2,3]. It means that during respiratory disease, people experience intestinal complications and vice versa [4]. Although COVID-19 is primarily a respiratory illness, the evidence suggests that the gastrointestinal tract may also play a role in the pandemic. 

New data has shown that patients with COVID-19 have an altered gut microbiome with depletion of beneficial bacteria (Eubacterium, Faecalibacterium, Roseburia, and Lachnospiraceae) and enrichment of opportunistic pathogens (Clostridium, Actinomyces, Bacteroides) during hospitalization [5, 6]. Additionally, the gut microbiome profiles of patients with severe symptoms were characterized by an increased presence of Coprobacillus, Clostridium ramosum, and Clostridium hathewayi. The level of Faecalibacterium prausnitzii (anti-inflammatory bacterium) has been inversely correlated with disease severity. These findings were confirmed in a larger study, where patients with COVID-19 had depleted levels of gut bacteria with known immunomodulatory potential, such as Faecalibacterium prausnitzii, Eubacterium rectale, and several bifidobacterial species [7].

Altered gut microbiota persisted even after recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), suggesting that the virus might have a prolonged negative effect on human microbiome balance [5,7]. The course of the disease may be more serious in people suffering from intestinal dysbiosis caused by chronic diseases, obesity, or even old age [8]. A dysbiotic gut environment increases levels of angiotensin-converting enzyme 2 (ACE2),  which is found in the small intestine among other sites, and is a key receptor for COVID-19 virus entry [9]. 

Gut Microbiome, Immune System and  COVID-19

The role of the immune system is to protect the body against diseases, harmful substances, germs, and neoplasms in addition to maintaining health [10]. An important player that significantly affects the immune system is the composition of the gut microbiome. The microbiome plays a fundamental role in the induction, training, and function of the host immune system [11]. In other words, balanced gut flora is critical for a healthy immune system. 

Scientists think that a healthy microbiome could be one of the factors responsible for a lower  fatality rate in COVID-19 patients and might be important to counteract the disease [6, 8]. A plant-based rich fiber diet, consumed by a majority of the population of India, appears to be advantageous, as it replenishes the host gut microbiota with beneficial microbes thereby leading to enhanced immunity [12]. Further, the implementation of lockdowns has resulted in the consumption of a home-cooked healthy diet for many. This helps in enriching the beneficial microflora in the gut, which might have resulted in a better prognosis of COVID-19 patients in India in comparison to that observed in western countries [12].

Woman Wearing Mask in Supermarket



In the absence of effective therapy against COVID-19 and the fact that your gut microbiome is altered, even after initial recovery from the virus, a correct personalized diet that can regulate the microbiome and its immune function might help minimize the impact of the disease and heal gut imbalance [3, 6, 8].  Therefore, we suggest taking the Olawell gut microbiome test to find out which dietary recommendations are most suitable for your body’s ability to prevent, fight, and recover from infections.


[1] Zhang, D., Li, S., Wang, N., Tan, H. Y., Zhang, Z., & Feng, Y. (2020). The cross-talk between gut microbiota and lungs in common lung diseases. Frontiers in Microbiology, 11.

[2] Dhar, D., & Mohanty, A. (2020). Gut microbiota and Covid-19-possible link and implications. Virus Research, 198018.

[3] Srinath, B. S., Shastry, R. P., & Kumar, S. B. (2020). Role of gut-lung microbiome crosstalk in COVID-19. Research on Biomedical Engineering, 1-11.

[4] Marsland, B. J., Trompette, A., & Gollwitzer, E. S. (2015). The gut–lung axis in respiratory disease. Annals of the American Thoracic Society, 12(Supplement 2), S150-S156.

[5] Zuo, T., Zhang, F., Lui, G. C., Yeoh, Y. K., Li, A. Y., Zhan, H., ... & Ng, S. C. (2020). Alterations in Gut Microbiota of patients with COVID-19 during time of hospitalization. Gastroenterology.

[6] Zeppa, S. D., Agostini, D., Piccoli, G., Stocchi, V., & Sestili, P. (2020). Gut Microbiota Status in COVID-19: An Unrecognized Player?. Frontiers in cellular and infection microbiology, 10.

[7] Yeoh, Y. K., Zuo, T., Lui, G. C. Y., Zhang, F., Liu, Q., Li, A. Y., ... & Ng, S. C. Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19. Gut.

[8] Janda, L., Mihalčin, M., & Šťastná, M. (2020). Is a healthy microbiome responsible for lower mortality in COVID-19?.. Biologia, 1-11.

[9] van der Lelie, D., & Taghavi, S. (2020). COVID-19 and the gut microbiome: more than a gut feeling

[10] Chowdhury, M. A., Hossain, N., Kashem, M. A., Shahid, M. A., & Alam, A. (2020). Immune response in COVID-19: A review. Journal of Infection and Public Health.

[11] Belkaid, Y., & Hand, T. W. (2014). Role of the microbiota in immunity and inflammation. Cell, 157(1), 121-141.

[12] Rishi, P., Thakur, K., Vij, S., Rishi, L., Singh, A., Kaur, I. P., ... & Kalia, V. C. (2020). Diet, gut microbiota and COVID-19. Indian Journal of Microbiology, 1-10.

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