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Is transplantation of intestinal microbiota safe and effective for mild cases of novel coronavirus?

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2021.09.09

EARLY RECOVERY FROM NOVEL CORONAVIRUS INFECTION AFTER UNDERGOING FMT

This is a report by Jarosław Biliński and his research team at the Medical University of Warsaw, Poland.

(Text of case report)
Rapid resolution of COVID-19 after fecal microbiota transplantation | Gut

(English article based on this paper)
Could a Stool Transplant Help Recovery in COVID-19 Patients? | Technology Networks

It has been reported that the composition of the intestinal flora changes when a person is exposed to a new type of coronavirus… [1] [2] The key point is that transplantation of intestinal flora to improve the intestinal flora can be helpful.

By the way, how is the “SARS-CoV2” mentioned in the report related to the new coronavirus (COVID-19), SARS-CoV2 is the name of the virus and COVID-19 is the name of the disease.

Because gut flora is closely related to the immune system and has been reported to be interconnected with the lungs as well… [3] it seems to be speculated that transplantation of intestinal flora may be effective in new coronavirus infections.

This case report describes the transplantation of intestinal microbiota in two CDI patients with symptoms of novel coronavirus infection.

Case 1: 80-year-old male with multiple diseases

[Patient Profile]
・80 year old male
・Has a history of CDI (Clostridioides difficile infection)
・Has multiple other medical complications
・Has been hospitalized for pneumonia and sepsis

THIS PATIENT WAS TREATED FOR PNEUMONIA WITH ANTIBIOTICS, BUT HAD A RECURRENCE OF CDI AND WAS GIVEN AN INTESTINAL MICROFLORA TRANSPLANT.

HOWEVER, ON THE DAY OF THE GUT MICROBIOTA TRANSPLANT, I DEVELOPED A FEVER AND MY CRP, AN INDEX OF INFLAMMATION, ALSO ROSE.

When tested, he tested positive for a new type of coronavirus (SARS-CoV-2).
Therefore, antiviral medications and CONVALESCENT PLASMA (CP, convalescent patient plasma therapy) were started.
Unexpectedly (it says), two days after FMT, her fever went down and her CRP level also went down.

Recovery patient plasma therapy” is a method being tested as a potentially effective treatment for new coronavirus infections. However, its effectiveness is still limited. (Reference: Recovery phase patient plasma)

Case 2: 19-year-old male, ulcerative colitis

[Patient Profile]
・19 year old male
・Affected with ulcerative colitis and on immunosuppressive drugs
・Hospitalized for CDI relapse

An antibiotic called vancomycin was administered for the purpose of treating CDI and the symptoms subsided.
Intestinal microflora transplantation via colonoscopy was performed for the purpose of preventing further CDI.

FIFTEEN HOURS AFTER THE GUT MICROBIOTA TRANSPLANT, HE DEVELOPED A 39-DEGREE FEVER AND HIS CRP LEVELS ROSE.

Upon testing, he also tested positive for a new type of coronavirus (SARS-CoV-2).
Since then, his fever has gone down and his CRP values have settled down.

New coronavirus infection status of patients and donors

At what point did the patient become infected with the novel coronavirus?

Case 1 patient
– Pre-admission testing negative
– Stool test just prior to FMT negative
– Stool test 7 days after FMT positive
– Stool test 14 days after FMT positive
– Stool test 30 days after FMT negative

Case 2 patient
– Pre-admission testing negative
– Stool test just prior to FMT negative
– Stool test 7 days after FMT positive
– Stool test 14 days after FMT unknown
– Stool test 30 days after FMT negative

THE DONOR HAS BEEN CONFIRMED NEGATIVE BY TWO NOSE-PLUG TYPE CORONA TESTS AT THE TIME OF STOOL DONATION AND A STOOL PCR TEST ON THE DONATED STOOL.

What can be derived from the two cases

The authors state that
“Transplantation of the gut microbiota is a safe and effective method for patients with recurrent CDI who are infected with novel coronaviruses.”


He further speculates
that “FMT may have made the clinical symptoms of new coronavirus infection less severe.

The two patients in this case are the type of patients who are likely to have severe coronas.


The antiviral drugs didn’t kick in until about 10 days, and none of the other treatments they were receiving had been shown to be effective against new coronavirus infections.”

IN ADDITION, THE STOOL PCR TEST FOR NOVEL CORONAVIRUS INFECTION USUALLY STAYS POSITIVE FOR ABOUT 27 TO 47 DAYS, BUT THESE PATIENTS TURNED NEGATIVE IN A SHORTER PERIOD OF TIME.

In fact, an Italian research team had a similar experience… [4] and the present report is further supportive of that.

I think this finding is a very, very interesting report and should not be overlooked.
Although pharmaceutical companies and the government have been leading the fight against coronas by saying that a vaccine would be safe for now, transplantation of intestinal microflora may be safer and more effective.

The research team will conduct clinical trials with a view to adding gut microbiota transplantation as a standard measure to prevent severe new coronavirus infections.

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