There is growing interest in the connection between the gut microbiome and COVID-19. With grant support from Danone North America, a team at Rutgers University including AGA member Vinod K. Rustgi, MD, MBA, is investigating whether an individual’s microbiome status is a predictor of clinical outcome in COVID-19 infection.
Vinod K. Rustgi, MD, MBA
Professor of Medicine
Robert Wood Johnson Medical School at Rutgers, The State University of New Jersey
1. Could you provide a brief description of the study underway at Rutgers and what inspired this study?
During the height of the pandemic in New Jersey last spring, we became aware of the effect of COVID-19 on the liver and the GI tract resulting in nausea, diarrhea as well as abnormal liver enzymes. There was some preliminary information about GI manifestations correlating with length of stay in the hospital as well as morbidity and mortality. We also became aware of the presence of ACE2 receptors in the GI tract as well as cholangiocytes. This led to the question of whether the microbiome had an influence on the disease state and vice versa.
Since we had wonderful expertise covering the microbiome on campus, we reached out to our research colleagues Drs. Martin Blaser, Jeffrey Carson, Reynold Panettieri, Daniel Horton, Emily Barrett, Jason Roy and Maria Laura Gennaro, and devised projects involving the adult and pediatric populations.
Our initial study involved collecting fecal samples from patients actively infected with SARS-CoV-2, those recovered from COVID-19 as well as healthy, normal controls. There are 20 in each group. Demographic data were collected as well as dietary histories, antibiotic usage in the prior 6 months as well as co-morbidities. The goal of this study was to examine changes in the microbiome related to disease status. Fecal samples of actively infected patients were also sent to Dr. Jake Liang at the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health for virologic studies.
2. Tell us about a challenge the investigator team has faced trying to move forward this project while the pandemic is still ongoing.
The logistics of fecal sample collection in an environment that required personal protective equipment proved difficult. Understandably, obtaining consent from concerned family members of sick, hospitalized patients required patience and, sometimes, multiple conversations and visits.
3. What are the potential implications of this study for clinicians?
Hopefully, our research colleagues will be able to elucidate changes in the microbiome that can be used to therapeutic advantage by clinicians to treat COVID-19.
This Q&A has been lightly edited for clarity.
