Probiotics may be beneficial in COVID-19 treatment

Probiotics are live microorganisms that confer health benefits when consumed in adequate amounts, including enhanced immune activity and the clearance of respiratory tract infections. (FAO and WHO, UN).

Probiotics could be used as an adjunctive treatment against COVID-19.

Role of probiotics to combat COVID-19

It is evident that probiotics can reduce the incidence and severity of diseases, suggesting their promise for treating or preventing COVID-19. Probiotics could help prevent COVID-19 by maintaining the human GI or lung microbiota because dysbiosis plays a major role in the susceptibility of people to infectious diseases.

Note: More in vitro and clinical studies are required to examine the potential preventive and curative effects of probiotics against SARS-CoV-2 infection.

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Probiotics in viral infections

Probiotics are “nonpathogenic living microorganisms providing various health benefits to the human host.” These include Lactobacillus and Bifidobacterium genera of bacteria, since these bacteria restore the balance of microbes in the gut.

Many findings indicate that such probiotics maintain a healthy host immune system that helps the body rebound after a respiratory viral infection in animal models. Not only did these interventions enhance the health of the animals, but lowered the viral load in their lungs and boosted survival rates.

Probiotic strains may help prevent infection, and enhance immune function to reduce the impact of viral infections, especially COVID-19.

Putative mechanisms by which probiotics may help manage coronavirus infection

( A ) Probiotic bacteria can hinder the adsorption process via directly binding to the virus and inhibiting entry into epithelial cells.

( B ) Binding of probiotic bacteria to the epithelial surface can cause steric hindrance and block the virus’s attachment to the host cell receptor.

( C ) Probiotic bacteria releases antimicrobial substances (such as bacteriocins, biosurfactants, lactic acid, hydrogen peroxide, nitric oxide, organic acids) and intestinal mucins from mucosal cells, which can effectively inhibit virus proliferation.

( D ) Virus neutralized by secretory antibodies like IgA.

( E ) Upon virus attack in epithelial cells, probiotics mediate their antiviral effects by eliciting immune responses by activating macrophages and dendritic cells.

( F ) Activation of immune response leads to differentiating CD8 + T lymphocytes into CTLs, capable of destroying virus-infected cells.

( G ) CD4 + T lymphocytes cells differentiate into Th1, which activates phagocytosis through NK cells and macrophages, promoting pathogen killing.

( H ) CD4 + cells differentiate into Th2 cells, which induce B-cells’ proliferation that produces antibodies like IgA, IgG, and IgM. CTLs, cytotoxic T-lymphocytes; Th1, T-helper cells type 1.

Immunomodulatory effects

Probiotics can modulate host immune responses and counteract the “cytokine storm” produced during COVID-19 infection.

A combination of three Lactobacillus strains induced an antiviral response, increasing the production of inflammatory cytokines and up regulating interferon regulatory factor-7 and other immunomodulatory genes.

· Probiotics boost the immune system, enhance the mucosal barrier function and inhibit bacterial adherence and invasion capacity in the intestinal epithelium by being in a direct antagonism with pathogenic bacteria.

· The gut-lung axis is involved in the pathogenicity of bacterial and viral infections, as the intestinal microbiota boosts the alveolar macrophage activity, thus having a protective role in host defense against pneumonia.

Along these lines, current clinical evidence connects gut, lung, and brain as an entity with communication mediated through complex neural, immunologic inflammatory and neuroendocrine networks, the so called gut-brain-lung axis.