Limited intestinal inflammation despite diarrhea, fecal viral RNA and SARS-CoV-2-specific IgA in patients with acute COVID-19
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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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SciScore for 10.1101/2020.09.03.20183947: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The study was reviewed and approved by the institutional review board at our medical center (Protocol #: HS# 16-00512/ GCO# 16-0583).
Consent: We enrolled patients who were able to give informed consent and were able to provide a stool sample.Randomization not detected. Blinding Information regarding subject’s participation on double blinded clinical trials was recorded. Power Analysis not detected. Sex as a biological variable The mean (SD) age in the control group was 52.1 (11.3) compared to 55.9 (15.1) of the COVID-19 cohort (p=0.3, t-test) and 9 healthy donors were male (40.9%) compared with 47.7% of the COVID-19 cohort. Table 2: Resources
Antibodies Sentences Res… SciScore for 10.1101/2020.09.03.20183947: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The study was reviewed and approved by the institutional review board at our medical center (Protocol #: HS# 16-00512/ GCO# 16-0583).
Consent: We enrolled patients who were able to give informed consent and were able to provide a stool sample.Randomization not detected. Blinding Information regarding subject’s participation on double blinded clinical trials was recorded. Power Analysis not detected. Sex as a biological variable The mean (SD) age in the control group was 52.1 (11.3) compared to 55.9 (15.1) of the COVID-19 cohort (p=0.3, t-test) and 9 healthy donors were male (40.9%) compared with 47.7% of the COVID-19 cohort. Table 2: Resources
Antibodies Sentences Resources Laboratory data were also collected via chart review, we included results for: SARS-CoV-2 nasal PCR, SARS-CoV-2 antibodies, peripheral WBC and lymphocyte percentage, Aspartate Aminotransferase (AST) SARS-CoV-2suggested: NoneSoftware and Algorithms Sentences Resources Amplicon Sequence Variants (ASVs) were classified using the Scikit-Learn plugin [50] using the Naive Bayes classifiers trained on the silva-132-99-515-806-nb-classifier. Scikit-Learnsuggested: (scikit-learn, RRID:SCR_002577)Reads were trimmed with Trimmomatic [52] and taxonomic assignments were generated with MetaPhlAn2[53]. Trimmomaticsuggested: (Trimmomatic, RRID:SCR_011848)MetaPhlAn2suggested: NoneData is deposited to NCBI under BioProject PRJNA660883. BioProjectsuggested: (NCBI BioProject, RRID:SCR_004801)Results from OddPub: Thank you for sharing your data.
Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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