The Intestinal and Oral Microbiomes Are Robust Predictors of COVID-19 Severity the Main Predictor of COVID-19-related Fatality [preprint]
AuthorsWard, Doyle V.
Qu, Ming Da
Mitchell, William G.
Yang, Jason D.
McCormick, Beth A.
Moormann, Ann M.
UMass Chan AffiliationsGraduate School of Biomedical Sciences
School of Medicine
Department of Pediatrics
Department of Internal Medicine
Department of Medicine, Division of Infectious Diseases and Immunology
Program of Microbiome Dynamics
Department of Microbiology and Physiological Systems
intestinal and oral microbiome
Environmental Public Health
Immunology of Infectious Disease
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AbstractThe reason for the striking differences in clinical outcomes of SARS-CoV-2 infected patients is still poorly understood. While most recover, a subset of people become critically ill and succumb to the disease. Thus, identification of biomarkers that can predict the clinical outcomes of COVID-19 disease is key to help prioritize patients needing urgent treatment. Given that an unbalanced gut microbiome is a reflection of poor health, we aim to identify indicator species that could predict COVID-19 disease clinical outcomes. Here, for the first time and with the largest COVID-19 patient cohort reported for microbiome studies, we demonstrated that the intestinal and oral microbiome make-up predicts respectively with 92% and 84% accuracy (Area Under the Curve or AUC) severe COVID-19 respiratory symptoms that lead to death. The accuracy of the microbiome prediction of COVID-19 severity was found to be far superior to that from training similar models using information from comorbidities often adopted to triage patients in the clinic (77% AUC). Additionally, by combining symptoms, comorbidities, and the intestinal microbiota the model reached the highest AUC at 96%. Remarkably the model training on the stool microbiome found enrichment of Enterococcus faecalis, a known pathobiont, as the top predictor of COVID-19 disease severity. Enterococcus faecalis is already easily cultivable in clinical laboratories, as such we urge the medical community to include this bacterium as a robust predictor of COVID-19 severity when assessing risk stratification of patients in the clinic.
medRxiv 2021.01.05.20249061; doi: https://doi.org/10.1101/2021.01.05.20249061. Link to preprint on medRxiv.
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/29675
This article is a preprint. Preprints are preliminary reports of work that have not been certified by peer review.
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Except where otherwise noted, this item's license is described as The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license.