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      Changes of gut microbiota under different nutritional methods in elderly patients with severe COVID-19 and their relationship with prognosis

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          Abstract

          Background

          The clinical progression of individuals afflicted with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection exhibits significant heterogeneity, particularly affecting the elderly population to a greater extent. Consequently, the association between nutrition and microbiota has garnered considerable interest. Hence, the objective of this study was to gather clinical data pertaining to the influence of diverse nutritional support interventions on the prognosis of geriatric patients with COVID-19, while additionally examining the fecal microbiota of these individuals to assess the repercussions of microecological alterations on their prognostic outcomes.

          Results

          A total of 71 elderly patients diagnosed with severe COVID-19 were included in this study. These patients were subsequently divided into two groups, namely the enteral nutrition (EN) group and the parenteral nutrition (PN) group, based on the type of nutritional support therapy they received after admission. The occurrence of complications was observed in 10.4% of patients in the EN group, whereas it was significantly higher at 69.6% in the PN group (P<0.001). Furthermore, the 60-day mortality rate was 2.1% (1/48) in the EN group, while it was notably higher at 30.4% (7/23) in the PN group (P=0.001). To identify the independent predictors of 60-day mortality, stepwise logistic regression analysis was employed. Among different bacterial groups, Enterococcus_faecium (18.19%) and Pseudomonas_aeruginosa (1.91%) had higher average relative abundance in the PN group (P<0.05). However, the relative abundance of Ruminococcus was higher in the EN group. Further Spearman correlation analysis showed that Enterococcus_faecium was positively correlated with poor clinical prognosis, while Ruminococcus was negatively correlated with poor clinical prognosis.

          Conclusions

          This study shows that the changes in the composition of intestinal flora in elderly COVID-19 patients receiving different nutritional support strategies may be related to different clinical outcomes. The abundance of Enterococcus_faecium in elderly COVID-19 patients receiving PN is significantly increased and is closely related to poor clinical outcomes. It highlights the potential of microbiome-centric interventions to mitigate and manage COVID-19 in older adults with different nutritional support options.

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          Most cited references50

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          Fast gapped-read alignment with Bowtie 2.

          As the rate of sequencing increases, greater throughput is demanded from read aligners. The full-text minute index is often used to make alignment very fast and memory-efficient, but the approach is ill-suited to finding longer, gapped alignments. Bowtie 2 combines the strengths of the full-text minute index with the flexibility and speed of hardware-accelerated dynamic programming algorithms to achieve a combination of high speed, sensitivity and accuracy.
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            Metagenomic biomarker discovery and explanation

            This study describes and validates a new method for metagenomic biomarker discovery by way of class comparison, tests of biological consistency and effect size estimation. This addresses the challenge of finding organisms, genes, or pathways that consistently explain the differences between two or more microbial communities, which is a central problem to the study of metagenomics. We extensively validate our method on several microbiomes and a convenient online interface for the method is provided at http://huttenhower.sph.harvard.edu/lefse/.
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              Fast and sensitive protein alignment using DIAMOND.

              The alignment of sequencing reads against a protein reference database is a major computational bottleneck in metagenomics and data-intensive evolutionary projects. Although recent tools offer improved performance over the gold standard BLASTX, they exhibit only a modest speedup or low sensitivity. We introduce DIAMOND, an open-source algorithm based on double indexing that is 20,000 times faster than BLASTX on short reads and has a similar degree of sensitivity.
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                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/2021129Role:
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                URI : https://loop.frontiersin.org/people/1688565Role:
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                URI : https://loop.frontiersin.org/people/1699551Role:
                URI : https://loop.frontiersin.org/people/2380659Role:
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                URI : https://loop.frontiersin.org/people/2094184Role:
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                Journal
                Front Immunol
                Front Immunol
                Front. Immunol.
                Frontiers in Immunology
                Frontiers Media S.A.
                1664-3224
                13 September 2023
                2023
                13 September 2023
                : 14
                : 1260112
                Affiliations
                [1] 1 Department of General Surgery (Endoscopic Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University , Guangzhou, China
                [2] 2 Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University , Guangzhou, China
                [3] 3 Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University , Guangzhou, China
                [4] 4 Key Laboratory of Human Microbiome and Chronic Diseases (Sun Yat-sen University), Ministry of Education , Guangzhou, China
                [5] 5 The Medical College of Xizang Minzu University , Xianyang, Shaanxi, China
                Author notes

                Edited by: Isabelle Wolowczuk, INSERM U1019 Centre d’Infection et Immunité de Lille (CIIL), France

                Reviewed by: Amruta Naik, University of Pennsylvania, United States; Veronica Ueckermann, University of Pretoria, South Africa

                *Correspondence: Xuefeng Guo, guoxfeng@ 123456mail.sysu.edu.cn ; Qinghua Zhong, zhongqh3@ 123456mail.sysu.edu.cn

                †These authors have contributed equally to this work

                Article
                10.3389/fimmu.2023.1260112
                10533997
                37781374
                1c953852-6d53-46a9-807a-52c47a8a4302
                Copyright © 2023 Zhang, Deng, Li, Su, Hu, Lin, Su, Chen, Liao, Bai, Lv, Xu, Zhong and Guo

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 17 July 2023
                : 30 August 2023
                Page count
                Figures: 11, Tables: 8, Equations: 0, References: 50, Pages: 19, Words: 8945
                Funding
                The authors declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by Supported by National Key Clinical Discipline.
                Categories
                Immunology
                Original Research
                Custom metadata
                Nutritional Immunology

                Immunology
                gut microbiota,enteral nutrition,parenteral nutrition,covid-19,old age
                Immunology
                gut microbiota, enteral nutrition, parenteral nutrition, covid-19, old age

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