Endotoxemia and circulating bacteriome in severe COVID-19 patients
Abstract Background When severe, COVID-19 shares many clinical features with bacterial sepsis. Yet, secondary bacterial infection is uncommon. However, as epithelium is injured and barrier function is lost, bacterial products entering the circulation might contribute to the pathophysiology of COVID-...
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| Language: | English |
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SpringerOpen
2020-12-01
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| Series: | Intensive Care Medicine Experimental |
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| Online Access: | https://doi.org/10.1186/s40635-020-00362-8 |
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| author | Phatadon Sirivongrangson Win Kulvichit Sunchai Payungporn Trairak Pisitkun Ariya Chindamporn Sadudee Peerapornratana Prapaporn Pisitkun Suwalak Chitcharoen Vorthon Sawaswong Navaporn Worasilchai Sarinya Kampunya Opass Putcharoen Thammasak Thawitsri Nophol Leelayuwatanakul Napplika Kongpolprom Vorakamol Phoophiboon Thitiwat Sriprasart Rujipat Samransamruajkit Somkanya Tungsanga Kanitha Tiankanon Nuttha Lumlertgul Asada Leelahavanichkul Tueboon Sriphojanart Terapong Tantawichien Usa Thisyakorn Chintana Chirathaworn Kearkiat Praditpornsilpa Kriang Tungsanga Somchai Eiam-Ong Visith Sitprija John A. Kellum Nattachai Srisawat |
| author_facet | Phatadon Sirivongrangson Win Kulvichit Sunchai Payungporn Trairak Pisitkun Ariya Chindamporn Sadudee Peerapornratana Prapaporn Pisitkun Suwalak Chitcharoen Vorthon Sawaswong Navaporn Worasilchai Sarinya Kampunya Opass Putcharoen Thammasak Thawitsri Nophol Leelayuwatanakul Napplika Kongpolprom Vorakamol Phoophiboon Thitiwat Sriprasart Rujipat Samransamruajkit Somkanya Tungsanga Kanitha Tiankanon Nuttha Lumlertgul Asada Leelahavanichkul Tueboon Sriphojanart Terapong Tantawichien Usa Thisyakorn Chintana Chirathaworn Kearkiat Praditpornsilpa Kriang Tungsanga Somchai Eiam-Ong Visith Sitprija John A. Kellum Nattachai Srisawat |
| author_sort | Phatadon Sirivongrangson |
| collection | DOAJ |
| description | Abstract Background When severe, COVID-19 shares many clinical features with bacterial sepsis. Yet, secondary bacterial infection is uncommon. However, as epithelium is injured and barrier function is lost, bacterial products entering the circulation might contribute to the pathophysiology of COVID-19. Methods We studied 19 adults, severely ill patients with COVID-19 infection, who were admitted to King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between 13th March and 17th April 2020. Blood samples on days 1, 3, and 7 of enrollment were analyzed for endotoxin activity assay (EAA), (1 → 3)-β-d-glucan (BG), and 16S rRNA gene sequencing to determine the circulating bacteriome. Results Of the 19 patients, 13 were in intensive care and 10 patients received mechanical ventilation. We found 8 patients with high EAA (≥ 0.6) and about half of the patients had high serum BG levels which tended to be higher in later in the illness. Although only 1 patient had a positive blood culture, 18 of 19 patients were positive for 16S rRNA gene amplification. Proteobacteria was the most abundant phylum. The diversity of bacterial genera was decreased overtime. Conclusions Bacterial DNA and toxins were discovered in virtually all severely ill COVID-19 pneumonia patients. This raises a previously unrecognized concern for significant contribution of bacterial products in the pathogenesis of this disease. |
| first_indexed | 2024-12-16T20:35:23Z |
| format | Article |
| id | doaj.art-b853ccdc37bf4bbd9196a8b2c1f2d4df |
| institution | Directory Open Access Journal |
| issn | 2197-425X |
| language | English |
| last_indexed | 2024-12-16T20:35:23Z |
| publishDate | 2020-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Intensive Care Medicine Experimental |
| spelling | doaj.art-b853ccdc37bf4bbd9196a8b2c1f2d4df2022-12-21T22:17:18ZengSpringerOpenIntensive Care Medicine Experimental2197-425X2020-12-018111510.1186/s40635-020-00362-8Endotoxemia and circulating bacteriome in severe COVID-19 patientsPhatadon Sirivongrangson0Win Kulvichit1Sunchai Payungporn2Trairak Pisitkun3Ariya Chindamporn4Sadudee Peerapornratana5Prapaporn Pisitkun6Suwalak Chitcharoen7Vorthon Sawaswong8Navaporn Worasilchai9Sarinya Kampunya10Opass Putcharoen11Thammasak Thawitsri12Nophol Leelayuwatanakul13Napplika Kongpolprom14Vorakamol Phoophiboon15Thitiwat Sriprasart16Rujipat Samransamruajkit17Somkanya Tungsanga18Kanitha Tiankanon19Nuttha Lumlertgul20Asada Leelahavanichkul21Tueboon Sriphojanart22Terapong Tantawichien23Usa Thisyakorn24Chintana Chirathaworn25Kearkiat Praditpornsilpa26Kriang Tungsanga27Somchai Eiam-Ong28Visith Sitprija29John A. Kellum30Nattachai Srisawat31Division of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial HospitalDivision of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial HospitalDepartment of Biochemistry, Faculty of Medicine, Chulalongkorn UniversityCenter of Excellence in Systems Biology, Chulalongkorn University (CUSB)Department of Microbiology, Chulalongkorn UniversityDivision of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial HospitalDivision of Allergy Immunology and Rheumatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDepartment of Biochemistry, Faculty of Medicine, Chulalongkorn UniversityDepartment of Biochemistry, Faculty of Medicine, Chulalongkorn UniversityDepartment of Microbiology, Chulalongkorn UniversityCenter of Excellence in Systems Biology, Chulalongkorn University (CUSB)Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn UniversityDeparment of Anesthesiology, Faculty of Medicine, Chulalongkorn UniversityDivision of Pulmonary and Critical Care, Department of Medicine, Faculty of Medicine, Chulalongkorn UniversityDivision of Pulmonary and Critical Care, Department of Medicine, Faculty of Medicine, Chulalongkorn UniversityDivision of Pulmonary and Critical Care, Department of Medicine, Faculty of Medicine, Chulalongkorn UniversityDivision of Pulmonary and Critical Care, Department of Medicine, Faculty of Medicine, Chulalongkorn UniversityCritical Care Excellence Center, King Chulalongkorn Memorial Hospital and Department of Pediatrics, Faculty of Medicine, Chulalongkorn UniversityDivision of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial HospitalDivision of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial HospitalDivision of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial HospitalCenter of Excellence in Immunology and Immune-Mediated Diseases, Department of Microbiology, Faculty of Medicine, Chulalongkorn UniversityDepartment of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDivision of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn UniversityTropical Medicine Cluster, Chulalongkorn UniversityDepartment of Microbiology, Chulalongkorn UniversityDivision of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial HospitalDivision of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial HospitalDivision of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial HospitalQueen Saovabha Memorial Institute, Thai Red Cross SocietyCenter for Critical Care Nephrology, The CRISMA Center, Department of Critical Care Medicine, University of Pittsburgh, School of MedicineDivision of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial HospitalAbstract Background When severe, COVID-19 shares many clinical features with bacterial sepsis. Yet, secondary bacterial infection is uncommon. However, as epithelium is injured and barrier function is lost, bacterial products entering the circulation might contribute to the pathophysiology of COVID-19. Methods We studied 19 adults, severely ill patients with COVID-19 infection, who were admitted to King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between 13th March and 17th April 2020. Blood samples on days 1, 3, and 7 of enrollment were analyzed for endotoxin activity assay (EAA), (1 → 3)-β-d-glucan (BG), and 16S rRNA gene sequencing to determine the circulating bacteriome. Results Of the 19 patients, 13 were in intensive care and 10 patients received mechanical ventilation. We found 8 patients with high EAA (≥ 0.6) and about half of the patients had high serum BG levels which tended to be higher in later in the illness. Although only 1 patient had a positive blood culture, 18 of 19 patients were positive for 16S rRNA gene amplification. Proteobacteria was the most abundant phylum. The diversity of bacterial genera was decreased overtime. Conclusions Bacterial DNA and toxins were discovered in virtually all severely ill COVID-19 pneumonia patients. This raises a previously unrecognized concern for significant contribution of bacterial products in the pathogenesis of this disease.https://doi.org/10.1186/s40635-020-00362-8COVID-19Critically illEndotoxemiaCirculating bacteriomeAcute respiratory distress syndromeSepsis |
| spellingShingle | Phatadon Sirivongrangson Win Kulvichit Sunchai Payungporn Trairak Pisitkun Ariya Chindamporn Sadudee Peerapornratana Prapaporn Pisitkun Suwalak Chitcharoen Vorthon Sawaswong Navaporn Worasilchai Sarinya Kampunya Opass Putcharoen Thammasak Thawitsri Nophol Leelayuwatanakul Napplika Kongpolprom Vorakamol Phoophiboon Thitiwat Sriprasart Rujipat Samransamruajkit Somkanya Tungsanga Kanitha Tiankanon Nuttha Lumlertgul Asada Leelahavanichkul Tueboon Sriphojanart Terapong Tantawichien Usa Thisyakorn Chintana Chirathaworn Kearkiat Praditpornsilpa Kriang Tungsanga Somchai Eiam-Ong Visith Sitprija John A. Kellum Nattachai Srisawat Endotoxemia and circulating bacteriome in severe COVID-19 patients Intensive Care Medicine Experimental COVID-19 Critically ill Endotoxemia Circulating bacteriome Acute respiratory distress syndrome Sepsis |
| title | Endotoxemia and circulating bacteriome in severe COVID-19 patients |
| title_full | Endotoxemia and circulating bacteriome in severe COVID-19 patients |
| title_fullStr | Endotoxemia and circulating bacteriome in severe COVID-19 patients |
| title_full_unstemmed | Endotoxemia and circulating bacteriome in severe COVID-19 patients |
| title_short | Endotoxemia and circulating bacteriome in severe COVID-19 patients |
| title_sort | endotoxemia and circulating bacteriome in severe covid 19 patients |
| topic | COVID-19 Critically ill Endotoxemia Circulating bacteriome Acute respiratory distress syndrome Sepsis |
| url | https://doi.org/10.1186/s40635-020-00362-8 |
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