COVID Severity Linked To Your Gut

Written by Christine Bishara MD

While everyone focuses on a “cure all” vaccine, why hasn’t anyone focused on why some people aren’t getting sick from COVID-19?

 

Originally published, September, 22, 2020.

The past six months have been monumental for all healthcare workers. While some were considered frontline heroes, some have had their offices closed and labeled as non-essential. There’s no denying one thing however–this Covid pandemic has placed every single person’s immune system on the frontline.

Since the pandemic affected the NYC area early, my husband, a Pulmonologist/Intensivist, was thrust on to the front lines in late March. From the beginning, he and I would have nightly conversations about his patients in the ICU and the treatment protocols they were using. I was interested to discover  that the majority of his sickest patients had very high levels of inflammatory markers and that some of the treatments being used focused on inhibiting one of these inflammatory markers–Interleukin-6. Interleukin-6 is also the inflammatory marker involved in the deadly Cytokine Storm that seems to cause havoc in vulnerable individuals leading to more severe covid related illness. I was also interested to hear that aside from the already identified high risk and vulnerable population of patients, a large portion of those in the ICU had a BMI of over 30. One night, during one of our conversations, my husband point blank asked me if those with high BMI’s had high IL-6 levels at baseline.

That’s when the lightbulb went off!

Interleukin 6 is a pro-inflammatory marker subclinically elevated in certain high risk individuals. This includes those with heart disease, diabetes and obesity. These were the same individuals frequently referred to as having “inflammation.” I began to try to put the pieces together of what he was seeing in his sickest ICU patients and what I already knew about the gut health of overweight and high risk patients.

Also, knowing that kids were not getting as sick as adults, I started focusing my attention on what in particular afforded children this protection. Children’s guts are overall healthier than adults. During our research, I honed in on a particular gut microbe called Bifidobacterium which was present in much higher levels in children than in adults. The levels start to decline as we age and are very low in the elderly and those with the risk factors noted, but what made this even more significant was that Bifidobacterium was also directly involved in inhibiting interleukin-6 levels and regulating the same immune pathways that COVID was affecting. The clinical findings seemed to add up, but I wanted to make sure that the molecular pathways were correlating with the clinical data, so along with two scientist colleagues, we further researched the molecular pathways and indeed they matched up. We believe the higher presence of this gut microbe which functions as an immune regulator is what is protecting children from more severe infection.

There have been numerous studies over the years on the benefits of Bifidobacterium, especially the strains prevalent in the pediatric population. Studies on the administration of Bifidobacterium in certain conditions including asthma, inflammatory bowel, necrotising enterocolitis and even influenza have shown positive results. We highlight this in our research article.

Our findings were sparked by a spontaneous conversation between two married physicians and catalyzed by doctors of various specialties. This is the beauty of medicine-doctors with different expertise coming together as we search for discoveries.

Estimates on the completion of a viable vaccine are Spring 2021 at the earliest.  While we wait, why not try to build our immune system holistically and supplement with probiotics containing Bifidobacterium? Probiotics represent a viable and virtually harmless addition to the current vitamin regimen we take ourselves and recommend to our patients. Until that day arrives, I’ll be enjoying my morning vitamin C and D “cocktail” with a dose of Bifidobacterium.