HONG KONG.- Commentators around the world have been describing the struggle against COVID-19 as a war, and they may be right in that you literally have to have balanced guts, to face the enemy. A new front in the conflict has been opened by a research team from The Chinese University of Hong Kong’s Faculty of Medicine, which has become the first in the world to discover that a series of “good” bacteria is missing in the gut of COVID-19 patients. They have an imbalance between “good” and “bad” bacteria in their “gut microbiota” and that makes them susceptible to infection. The seriousness of their illness correlates to how well or poorly the bacteria in their gut are balanced.

Reinforcement is on the way from something that can be found in foods as gentle as yoghurt. Some eccentric solutions have been floated to the cure of COVID-19 and to say that yoghurt was the answer would be just adding to them. However, yoghurt does hold a clue. It contains probiotics, which are live, “good” bacteria that help keep your gut healthy. When you lose “good” bacteria in your body, probiotics can help replace them.

In response to their discovery, the research team led by Professor Ng Siew-chien, Associate Director of the Faculty’s Centre for Gut Microbiota Research has developed a probiotic supplement carefully composed to become part of the diet to help increase good gut bacteria.

It was because the team knew that gut microbiota had a role in the prevention of other diseases that they set out to look into the gut for clues to COVID-19. Professor Paul Chan Kay Sheung of the Department of Microbiology explains that there are 100 trillion bacteria, good and bad, which make up gut microbiota but certain bacteria strains found in all healthy individuals regulate the digestive system, modulate immune function and act as a barrier against infections. He describes the system as so complex, it can be considered a separate organ of the body.




In February and March, stool specimens were collected from 15 COVID-19 patients who had been hospitalized until discharge in conditions ranging from mild to critically ill. The research team studied the microorganisms in the patients’ guts and compared them with those from healthy individuals. All of the patients had an imbalance in their gut microbiota; the greater the dysbiosis, the more severe the infection. Though certain patients could already had an imbalance towards bad bacteria before catching the virus, the imbalance in most cases likely came from the virus attacking the gut. The imbalance will stay with the patients for a long time, even after recovery. The team will be following up with the 15 to monitor progress.

The research was then expanded. Data was collected on the gut microbiome of 150 COVID-19 patients and 1,500 healthy individuals. Using big data analysis, the team identified the strains of bacteria the patients lacked and by following a processing protocol to enhance the stability and quantity of live bacteria, they worked out a probiotic formula which targets gut dysbiosis in COVID-19.

Professor Ng makes the point that the composition of microorganisms in our gut can be altered by diet or lifestyle. “What appears to be useful in the West may not be as beneficial among Asian populations. Our probiotic formula is derived from data from the Chinese population.”

The research team believes that the formula they have developed overcomes the limitations on currently available probiotic products. For example, many probiotic bacteria perish from gastric acid, high temperature and humidity. The shelf-life of many probiotic products is short.

CU Medicine has applied for patents for this probiotic innovation in China and the U.S. and is now collaborating with innovation and technology companies and food companies to turn the formula into a probiotic supplement that can be added into the daily diet. The team is hoping that the innovation can reach the public within months.

However, Professor Francis KL Chan, Dean of CU Medicine, sounds a note of caution. The probiotic is, at this point, just a supplement and should not be looked to as a treatment. They are now working on large-scale clinical trials to provide further scientific evidence on the importance of gut health in preventing infectious diseases. “This will be a novel approach in the combat of COVID-19,” he says. “We must identify the composition of intestinal bacteria that helps maintain our defence. From there on, we can modulate the gut microbiota to boost our immunity against viral and bacterial infections.” The battle goes on.