Nasal microbiota holds clues to who will develop symptoms from novel coronavirus

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Sadanand Fulzele left and Dr. This nasopharyngeal microbiota is generally considered a frontline protection against viruses, bacteria and other pathogens that enter these natural passageways, says Dr. Distinct patterns emerged when the researchers examined the microbiota of 27 individuals age 49 to 78 who were negative for the virus, 30 who were positive but had no symptoms, and 27 who were positive with moderate symptoms that did not require hospitalization, they report in the journal Diagnostics.

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The most significant changes were in those who were symptomatic, including about half those patients not having a sufficient amount of microbiota to even sequence, says corresponding author Fulzele. The vast majority of the positive individuals with no symptoms still had sufficient microbiota, notes first author Kolhe.

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Based on experience with microbiota in the gastrointestinal tract, Kolhe thinks the different microbiota content and size is another good bet and they both would like a definitive answer. They found differences in the type of bacteria as american diabetes association facebook, although the researchers note that the function of some of the bacteria they found are not well understood.

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The moist, mucus-producing lining of this area works like a natural barrier to invaders and there also is a significant complement of immune cells present, Fulzele says, and their response to respiratory viruses is key. Their new findings indicate that the altered microbiota in the symptomatic patients impacted their immune response to the virus, Kolhe and Fulzele say.

Nasal microbiota holds clues to who will develop symptoms from novel coronavirus

The symptomatic individuals had significantly higher levels of two bacterial species, including Cutibacterium, generally found on the skin and associated with acne but also with heart infection and shoulder infections following surgery. Conversely there was a significantly lower presence of a handful of other, not well-studied bacterium.

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The microbiota of both infected groups, symptomatic and asymptomatic, had high levels of bacterium like Cyanobacteria, also called blue green algae, that can be found in contaminated water but is a usual inhabitant of the microbiome in humans which appears to have a role in regulating the immune response.

These bacterium typically enter the body through mucosal surfaces, like those in the nose, and are known to cause pneumonia and liver damage. Those who were symptomatic had twice as much of this bacterium as their asymptomatic counterparts.

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Fulzele notes that between the asymptomatic and symptomatic there was no significant change in microbiota diversity — just those big differences in volume — but they did see a lot of individual bacterium moving up and down in numbers. For example, their graph of the american diabetes association facebook of another water-loving bacterium Amylibacter, looked like stair steps as it moved from negative to positive with symptoms individuals, while there was a downward trend in a handful of other bacterium.

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Their analysis was done before the current virus variants began to surface, but the researchers say the differences in the microbiota likely will hold for these as well and they have already begun that analysis. Larger studies are needed to ensure that the clear patterns they found hold, the researchers say.

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They are putting together a grant application that will enable a larger study and looking for other testing sites who want to be partners. Using the same nasopharyngeal swab used for many COVID tests would enable a microbiota analysis to be done at the same time as testing, they say.

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They note the striking contrast that has emerged over nearly two years of experience with the virus, with the majority of those infected being asymptomatic or experiencing mild symptoms like they would with a cold, while others get severe viral pneumonia, require hospitalization and die. A myriad of other conditions like inflammatory bowel syndrome, peptic ulcers and viral diseases have been linked to significant changes in the microbiota of the gut, nasal and oral cavity, they write.

The work was supported in part by the National Institutes of Health. Read the full study.

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