Effect of nasal carriage of <i>Bacillus</i> species on COVID-19 severity: a cross-sectional study

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ABSTRACT

Intranasal sprays containing Bacillus species are being researched for treating viral respiratory tract infections. The aim of this study was to assess the relationship between the nasal carriage of Bacillus and COVID-19 severity. This was a cross-sectional study that collected nasopharyngeal samples from adults 18 years and above visiting two COVID-19 testing centers in Lagos, Nigeria, between September 2020 and September 2021. Bacillus species were cultured from the samples and confirmed using 16 s rRNA gene sequencing. The dependent variable was COVID-19 status classified as negative, asymptomatic, mild, or severe. The independent variable was the nasal carriage of Bacillus species. Multinomial regression analysis was done to determine the association between nasal carriage of Bacillus and COVID-19 severity after adjusting for age, sex, and co-morbidity status. A total of 388 participants were included in the study with mean (standard deviation) age of 40.05 (13.563) years. Sixty-one percent of the participants were male, 100 (25.8%) had severe COVID-19, 130 (33.5%) had pre-existing comorbidity, and 76 (19.6%) had Bacillus cultured from their nasopharyngeal specimen. Bacillus species presence was significantly associated with higher odds of severe COVID-19 compared to having a negative COVID-19 status (AOR = 3.347, 95% CI: 1.359, 8.243). However, the presence of Bacillus species was significantly associated with lower odds of severe COVID-19 compared to having a mild COVID-19 status. The study suggests that nasal carriage of Bacillus species is associated with the clinical course of COVID-19 and supports the exploration of Bacillus species in the management of viral respiratory tract infections.

IMPORTANCE

With the introduction of intranasal spray containing Bacillus species for the treatment of viral respiratory tract infections, such as COVID-19 and respiratory syncytial virus, identifying the association between the nasal carriage of Bacillus species and COVID-19 susceptibility and severity will help further substantiate the investigation of these bacteria for COVID-19 prevention and treatment. This study evaluated the association between the carriage of Bacillus species in the nasopharyngeal tract and COVID-19 severity and found that the presence of Bacillus species in the nasopharynx may significantly impact the clinical course of COVID-19.

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Most cited references 46

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Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Fei Zhou, Ting Yu, Ronghui Du … (2020)

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

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Genomewide Association Study of Severe Covid-19 with Respiratory Failure

David Ellinghaus, Frauke Degenhardt, Luis Bujanda … (2020)

Abstract Background There is considerable variation in disease behavior among patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19). Genomewide association analysis may allow for the identification of potential genetic factors involved in the development of Covid-19. Methods We conducted a genomewide association study involving 1980 patients with Covid-19 and severe disease (defined as respiratory failure) at seven hospitals in the Italian and Spanish epicenters of the SARS-CoV-2 pandemic in Europe. After quality control and the exclusion of population outliers, 835 patients and 1255 control participants from Italy and 775 patients and 950 control participants from Spain were included in the final analysis. In total, we analyzed 8,582,968 single-nucleotide polymorphisms and conducted a meta-analysis of the two case–control panels. Results We detected cross-replicating associations with rs11385942 at locus 3p21.31 and with rs657152 at locus 9q34.2, which were significant at the genomewide level (P<5×10−8) in the meta-analysis of the two case–control panels (odds ratio, 1.77; 95% confidence interval [CI], 1.48 to 2.11; P=1.15×10−10; and odds ratio, 1.32; 95% CI, 1.20 to 1.47; P=4.95×10−8, respectively). At locus 3p21.31, the association signal spanned the genes SLC6A20, LZTFL1, CCR9, FYCO1, CXCR6 and XCR1. The association signal at locus 9q34.2 coincided with the ABO blood group locus; in this cohort, a blood-group–specific analysis showed a higher risk in blood group A than in other blood groups (odds ratio, 1.45; 95% CI, 1.20 to 1.75; P=1.48×10−4) and a protective effect in blood group O as compared with other blood groups (odds ratio, 0.65; 95% CI, 0.53 to 0.79; P=1.06×10−5). Conclusions We identified a 3p21.31 gene cluster as a genetic susceptibility locus in patients with Covid-19 with respiratory failure and confirmed a potential involvement of the ABO blood-group system. (Funded by Stein Erik Hagen and others.)

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Co-infections in people with COVID-19: a systematic review and meta-analysis

Louise Lansbury, Benjamin W.H. Lim, Vadsala Baskaran … (2020)

Highlights • SARS-CoV-2, the cause of COVID19 disease, has spread globally since late 2019 • Bacterial coinfections associated with mortality in previous influenza pandemics • Proportion of COVID19 patients with bacterial coinfection less than in flu pandemics • Higher proportion of critically-ill with bacterial coinfections than in mixed setting • Bacterial co-pathogen profiles different to those in influenza co-infections • Fungal coinfection diagnosis difficult so high level suspicion in critically-ill

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Author and article information

Contributors

Muinah A. Fowora:

ORCID: https://orcid.org/0000-0001-7140-2689

Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review and editing

Adenike Aiyedogbon: Role: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: Writing – review and editing

Ibilola Omolopo: Role: Data curationRole: InvestigationRole: MethodologyRole: VisualizationRole: Writing – review and editing

Ahmed O. Tajudeen: Role: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: Writing – review and editing

Abdul-Lateef Olanlege: Role: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – review and editing

Adefunke Abioye: Role: InvestigationRole: MethodologyRole: Writing – review and editing

Grace B. Akintunde: Role: Formal analysisRole: InvestigationRole: SupervisionRole: Writing – review and editing

Babatunde L. Salako: Role: Funding acquisitionRole: ResourcesRole: SupervisionRole: Writing – review and editing

Montarop Yamabhai: Role: Editor

Journal

Journal ID (nlm-ta): Microbiol Spectr

Journal ID (iso-abbrev): Microbiol Spectr

Journal ID (publisher-id): spectrum

Title: Microbiology Spectrum

Publisher: American Society for Microbiology (1752 N St., N.W., Washington, DC )

ISSN (Electronic): 2165-0497

Publication date (Electronic, collection): February 2024

Publication date (Electronic, pub): 09 January 2024

Publication date PMC-release: 09 January 2024

Volume: 12

Issue: 2

Electronic Location Identifier: e01843-23

Affiliations

[1 ]Molecular Biology and Biotechnology Department, Nigerian Institute of Medical Research, Yaba; , Lagos, Nigeria

[2 ]Department of Science Laboratory Technology, Faculty of Science., Lagos State University; , Ojo, Lagos, Nigeria

[3 ]Infectious Diseases Hospital; , Lagos, Nigeria

Suranaree University of Technology; , Meung, Nakhon Ratchasima, Thailand

Author notes

Address correspondence to Muinah A. Fowora, muinahj@ 123456yahoo.com

The authors declare no conflict of interest.

Author information

Muinah A. Fowora https://orcid.org/0000-0001-7140-2689

Article

Publisher ID: 01843-23 Publisher ID: spectrum.01843-23

DOI: 10.1128/spectrum.01843-23

PMC ID: 10846055

PubMed ID: 38193730

SO-VID: 3a92208b-2bcd-40b9-bb8c-4f1872b987d8

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.

History

Date received : 02 May 2023

Date accepted : 06 December 2023

Page count

supplementary-material: 0, authors: 8, Figures: 1, Tables: 2, References: 49, Pages: 9, Words: 5840

Funding

Funded by: Nigerian Institute of Medical Research (NIMR);

Award ID: NMG-CIF-18-0036

Award Recipient : Muinah A. Fowora

Funded by: Royal Society of Tropical Medicine and Hygiene (RSTMH);

Award Recipient : Muinah A. Fowora

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cover-date February 2024

Keywords: covid-19,bacillus species,nasal spray,severity

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Keywords: covid-19, bacillus species, nasal spray, severity

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Effect of nasal carriage of Bacillus species on COVID-19 severity: a cross-sectional study

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ABSTRACT

IMPORTANCE

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Novel Coronavirus Disease COVID-19

Most cited references 46

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Genomewide Association Study of Severe Covid-19 with Respiratory Failure

Co-infections in people with COVID-19: a systematic review and meta-analysis

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