Thank you for this vintage photo.
We are in, “The Age of Covid-19” right now. All of us. We keep hearing about “the new normal” and how we will manage in this “new world.” For many of us who have had ill children and young adults with immune issues, some of this is a world that we have already inhabited. It has always included washing your hands excessively, keeping your distance from sick people, avoiding crowds, not touching doorknobs, etc. I have been a follower of microbiome research and autism, as it has been pivotal for my daughter having better days of health and life. The devastation that we are seeing with a novel virus hitting the populations around the globe has some overlap.
A recent study came out of China, Evidence for Gastrointestinal Infection of SARS-CoV-2
We are not hearing about this enough, so I need to share this information, that more than half of Covid-19 patients have gastrointestinal issues as they are becoming infected with the virus. Some important facts on that topic:
- After viral entry, virus-specific RNA and proteins are synthesized in the cytoplasm to assemble new virions,7 which can be released to the gastrointestinal tract.
- Therefore, fecal-oral transmission could be an additional route for viral spread.
- In more than 20% of patients with SARS-CoV-2, we observed that the test result for viral RNA remained positive in feces, even after test results for viral RNA in the respiratory tract converted to negative, indicating that the viral gastrointestinal infection and potential fecal-oral transmission can last even after viral clearance in the respiratory tract.
- Our results highlight the clinical significance of testing viral RNA in feces by real-time reverse transcriptase polymerase chain reaction (rRT-PCR) because infectious virions released from the gastrointestinal tract can be monitored by the test.
Influenza and other respiratory viral infections predispose patients to secondary bacterial super-infections, which are frequently associated with a more severe clinical course. ...This raises the possibility that disruptions in the normal microbial communities by an acute viral infection might contribute to the development of post-viral bacterial pneumonia….Interactions between respiratory tract infections and the gut microbiome are bidirectional. While respiratory viral infections can change the gut microbiome, the gut microbiome also shapes the adaptive immune responses against respiratory pathogens.
Here is an interesting article with an interview, How Bacteria Could Affect Outcomes Of COVID-19 Patients “As the COVID-19 pandemic continues, scientists are racing to unravel every aspect of how this novel virus behaves. The elderly, those with pre-existing conditions and members of disadvantaged communities with less access to health care have the worst outcomes. But what scientists don't understand is why some people who fall outside those groups are also being hospitalized — in some cases dying — while others are not….Among those trying to figure that out is Dr. Ronald Collman, a microbiologist and professor of medicine at the University of Pennsylvania, who thinks that our microbiome — the bacteria and fungi that live in our bodies and on our skin — may be playing a role.
While most healthy people have very little bacteria or fungi in the lungs, the nature of those microbes changes when people develop a disease, he says. The range of microbes present throughout our bodies determines how the immune system responds…….
Another recent study, not yet peer reviewed, also was done, Gut microbiota may underlie the predisposition of healthy individuals to COVID-19, showing the growing importance of this research.
We have heard in the news about symptoms of this virus. A brand new study, Neurological complications of coronavirus and COVID-19 tells us more - Coronaviruses are not always confined to the respiratory tract, and under certain conditions they can invade the central nervous system and cause neurological pathologies. . Neurological symptoms have been reported in patients affected by COVID-19, such as headache, dizziness, myalgia and anosmia, as well as cases of encephalopathy, encephalitis, necrotising haemorrhagic encephalopathy, stroke, epileptic seizures, rhabdomyolysis and Guillain-Barre syndrome, associated with SARS-CoV-2 infection.
There seems to be evidence that again, having a good microbiome can protect against some of that damage - Gut microbes protect against neurologic damage from viral infections
How might this damage be happening?
While COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, is generally a respiratory infection with coughing and shortness of breath as key features of the illness, some people have reported other symptoms, including loss of smell, heart trouble, and diarrhea...Scientists say that these non-lung symptoms might also be good indicators of SARS-CoV-2. Once inside a person’s body, the novel coronavirus attaches to a protein on human cells called angiotensin-converting enzyme 2 (ACE2). This enzyme, which is normally involved in blood pressure regulation, sits on the surface of different types of cells, including those in the brain, blood vessels, heart, intestines, and kidneys….
In children, we are hearing about increasing cases of Kawasaki Disease associated with Covid 19. Very scary. Interestingly, Kawasaki Disease has a long line of research connecting it to a very imbalanced microbiome.
The Neuropsychiatric Imprint
There have been cases of Covid-19 presenting with neuropsychiatric symptoms. As a result, researchers have looked into people being exposed to the novel coronavirus (COVID-19) and an increased risk of neuropsychiatric symptoms such as encephalopathy, psychosis, depression and mood changes.
Viral shedding in feces of COVID-19 patients is known to occur for at least five weeks post-infection (Yongjian Wu et al., 2020). Although the extent and mechanisms of viral infiltration of gut epithelium by SARS-CoV-2 are currently unknown, ACE2 is expressed by gut epithelial cells, and almost 40% of COVID-19 patients present with gastrointestinal (GI) symptoms (Zhang et al., 2020). As such, gastroenterologists performing fecal microbiota transplantation (FMT) to treat C. difficile have identified the need to screen donors for potential GI infiltration by SARS-CoV-2 (Ianiro et al., 2020). It may be the case that SARS-CoV-2 infection precipitates changes in gut microbial composition, which could be involved in the pathogenesis of neuropsychiatric symptoms via the gut-brain axis; this remains largely speculative, but is mechanistically feasible (Li et al., 2019)...
Studies of past respiratory viral pandemics suggest that diverse types of neuropsychiatric symptoms can arise in the context of acute viral infection, or after variable periods of time post-infection. Reports from the 18th and 19th centuries suggest that influenza pandemics in particular have been marked by increased incidences of various neuropsychiatric symptoms, such as insomnia, anxiety, depression, mania, psychosis, suicidality, and delirium (Honigsbaum, 2013, Menninger, 1926). For instance, encephalitis lethargica (EL) is an inflammatory disorder of the CNS marked by hypersomnolence, psychosis, catatonia, and Parkinsonism, the incidence of which increased around the time of the “Spanish” influenza pandemic of the early 20th century (Von Economo, 1932).
Future Treatments for the Microbiome in Covid-19?
NOTE: These are for discussion purposes only and please consult a doctor if you have any questions about your health.
There are not many treatments yet for Covid-19. Prevention, besides washing your hands and social distancing, is not yet established, though the search for a vaccine is discussed daily - At least 90 potential COVID-19 vaccines are under study, and six of those are already being tested on humans in phase I clinical trials to determine if they’re safe….Anthony Fauci, MD, a member of the White House coronavirus task force and director of the National Institute of Allergy and Infectious Diseases, has often cited a possible 12- to 18-month timeline.
And that is probably extremely optimistic, says Paul Offit, MD, director of the Vaccine Education Center and attending physician in the Division of Infectious Diseases at Children's Hospital of Philadelphia. "I don't see how 12 to 18 months is possible," he says. "That is ridiculously fast."
Some researchers think there may never be an effective vaccine for Covd-19:
It’s possible, Roper fears, that COVID-19 could be a virus that proves resistant to vaccination. “This may be one,” she says. “If we have one, this is going to be it, I think.” The FDA has never approved a vaccine for humans that is effective against any member of the coronavirus family, which includes SARS, MERS, and several that cause the common cold….In a worse-case scenario, a phenomenon called “immune enhancement” can cause vaccines to make the symptoms of infections worse. Instead of preventing the virus from entering healthy cells, the antibodies actually help them to do so. In 2016, after some 800,000 Filipino schoolchildren were given a dengue-fever vaccine called Dengvaxia, officials realized that some of them had been put at increased risk of life-threatening complications. Investigators wound up looking into the deaths of some 600 children who’d taken part.
Since antibodies continue to be perplexing with this dangerous virus, that could be a stark reality. Here are some treatment ideas that seem to have research showing potential benefit:
--- There is research showing that “ bismuth‐based drugs” may possibly be a medication that can be used to “dramatically reduce replication in infected cells”:
This is intriguing for a number of reasons but obviously it is microbiome-related. Researchers in China have decided to pursue this in a clinical trial:
A randomized, double-blind, placebo-controlled trial for evaluation of the efficacy and safety of bismuth potassium citrate capsules in the treatment of patients with Novel coronavirus pneumonia (COVID-19).
--- VItamin D3 and the microbiome have a critical connection. I have been researching that for quite awhile.
Here is a very recent study showing that low levels of Vit D3 are connected to severe cases of Covid-19. Vitamin D Insufficiency is Prevalent in Severe COVID-19
--- Based on the present expert consensus carried out by National Health Commission and National Administration of Traditional Chinese Medicine, our team summarized and established an effective treatment strategy centered on "Four-Anti and Two-Balance" for clinical practice. The "Four-Anti and Two-Balance"strategy included antivirus, anti-shock, anti-hyoxemia, anti-secondary infection, and maintaining of water, electrolyte and acid base balance and microecological balance….The "Four-Anti and Two-Balance"strategy effectively increased cure rate and reduced mortality. Early antiviral treatment could alleviate disease severity and prevent illness progression, and we found lopinavir/ritonavir combined with abidol showed antiviral effects in COVID-19….Some patients with COVID-19 showed intestinal microbial dysbiosis with decreased probiotics such as Lactobacillus and Bifidobacterium. Nutritional and gastrointestinal function should be assessed for all patients. Nutritional support and application of prebiotics or probiotics were suggested to regulate the balance of intestinal microbiota and reduce the risk of secondary infection due to bacterial translocation.
--- Vitamin C:
Intravenous vitamin C for reduction of cytokines storm in acute respiratory distress syndrome. The protective action of ascorbic acid is shown in . A high dose IV Vit-C was used in 2009 to treat a New Zealand farmer (Primal Panacea) . Vit-C was able to cut down ICU stay through an analysis of 18 clinical studies on 2004 ICU patients . It was found that 17,000 mg/day IV Vit-C had shortened the ICU stay by 44 %. The use of IV Vit-C in 47 sepsis ICU cases was reported and a major reduction in death was possible . Dietary antioxidants (Vit-C and sulforaphane) were helpful to manage oxidative-stress-induced acute inflammatory lung injury that requires mechanical ventilation . Another antioxidant, natural curcumin has also been effective against inflammation that caused during pneumonia . National Institutes of Health (NIH) states that high dose IV Vit-C (1.5 g/kd body weight) is safe for good health and without side effects .
Vitamin C is best known for its antioxidant properties, being able to scavenge damaging reactive oxygen species, thus protecting the body’s cells and tissues from oxidative damage and dysfunction. However, the vitamin also has numerous other important functions within the body, many of which are known to support healthy immune function. During infection, vitamin C levels can become depleted and a person’s requirement for vitamin C increases with the severity of the infection . In severe cases, this may require intravenous administration of gram doses in order to achieve high enough levels in the body to compensate for the enhanced turnover of the vitamin...Just recently registered on clincialtrials.gov (Identifier: NCT04264533), a new clinical trial to investigate vitamin C infusion for the treatment of severe 2019-nCoV infected pneumonia has begun in Wuhan, China. This is one of the first RCTs to test the effects of IV vitamin C in patients infected with this virus. In this trial, the investigators will treat 140 patients with a placebo control or intravenous vitamin C at a dose of 24 g/day for 7 days. They will assess requirements for mechanical ventilation and vasopressor drugs, organ failure scores, ICU length of stay and 28-day mortality.
--- Other candidates include, quercetin, cinnamon, licorice extract, and selenium.
To good health, safe treatments, and a return to normalcy.
Teresa Conrick is Science Editor for Age of Autism.