Limited Intestinal Inflammation Despite Diarrhea, Fecal Viral RNA and SARS-CoV-2-specific IgA in Patients with Acute COVID-19

Overview

Journal Sci Rep

Specialty Science

Date 2021 Jun 26

PMID 34172783

Citations 45

Authors

Graham J Britton

Alice Chen-Liaw

Francesca Cossarini

Alexandra E Livanos

Matthew P Spindler

Tamar Plitt

Joseph Eggers

Ilaria Mogno

Ana S Gonzalez-Reiche

Sophia Siu

Michael Tankelevich

Lauren Tal Grinspan

Rebekah E Dixon

Divya Jha

Adriana van de Guchte

Zenab Khan

Gustavo Martinez-Delgado

Fatima Amanat

Daisy A Hoagland

Benjamin R tenOever

Marla C Dubinsky

Miriam Merad

Harm van Bakel

Florian Krammer

Gerold Bongers

Saurabh Mehandru

Jeremiah J Faith

Affiliations

Soon will be listed here.

Abstract

Gastrointestinal symptoms are common in COVID-19 patients but the nature of the gut immune response to SARS-CoV-2 remains poorly characterized, partly due to the difficulty of obtaining biopsy specimens from infected individuals. In lieu of tissue samples, we measured cytokines, inflammatory markers, viral RNA, microbiome composition, and antibody responses in stool samples from a cohort of 44 hospitalized COVID-19 patients. SARS-CoV-2 RNA was detected in stool of 41% of patients and more frequently in patients with diarrhea. Patients who survived had lower fecal viral RNA than those who died. Strains isolated from stool and nasopharynx of an individual were the same. Compared to uninfected controls, COVID-19 patients had higher fecal levels of IL-8 and lower levels of fecal IL-10. Stool IL-23 was higher in patients with more severe COVID-19 disease, and we found evidence of intestinal virus-specific IgA responses associated with more severe disease. We provide evidence for an ongoing humeral immune response to SARS-CoV-2 in the gastrointestinal tract, but little evidence of overt inflammation.

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