Two-year follow-up of gut microbiota alterations in patients after COVID-19: from the perspective of gut enterotype

作者：Qinfen Xie, Jiali Ni, Wanru Guo, Cheng Ding, Fengjiao Wang, Yechen Wu, Yuxi Zhao, Lingxiao Zhu, Kaijin Xu, Yanfei Chen · 发表于：Microbiology Spectrum · 年份：2025 · DOI：10.1128/spectrum.02774-24 · 被引用次数：7 · 研究领域：Gut microbiota and health、Clostridium difficile and Clostridium perfringens research、Microscopic Colitis

ABSTRACT Gut microbiota dysbiosis plays a role in the pathogenesis of post-acute coronavirus disease (COVID-19); however, the long-term recovery of the gut microbiota following SARS-CoV-2 infection remains insufficiently understood. In this study, 239 fecal samples were collected from 87 COVID-19 patients during the acute phase, and at 6 months, 1 year, and 2 years post-discharge. An additional 48 fecal samples from non-COVID-19 controls were also analyzed. Gut enterotypes were determined through 16S rRNA sequencing, and dynamic changes from the acute phase through recovery were assessed. Correlations between enterotypes and clinical characteristics were also examined. Two distinct enterotypes were identified: a Blautia-dominated enterotype (Enterotype-B) and a Streptococcus-dominated enterotype (Enterotype-S). Species diversity and richness were significantly higher in Enterotype-B. Enterotype-S, associated with inflammation, was more prevalent during the acute phase. Six months post-discharge, the ratio of Enterotype-B to Enterotype-S approached normal levels. Patients with Enterotype-S at admission had a higher incidence of severe cases during hospitalization and a longer duration of nasopharyngeal viral shedding compared with those with Enterotype-B. Furthermore, at 6 months post-discharge, residual pulmonary Computed Tomography (CT) abnormalities were more common in patients with Enterotype-S (55%) than in those with Enterotype-B (20%, P = 0.046). An index, B/S, represen...