Oral Bacteriotherapy in Patients With COVID-19: A Retrospective Cohort Study.
Identifieur interne : 000431 ( Main/Corpus ); précédent : 000430; suivant : 000432Oral Bacteriotherapy in Patients With COVID-19: A Retrospective Cohort Study.
Auteurs : Giancarlo Ceccarelli ; Cristian Borrazzo ; Claudia Pinacchio ; Letizia Santinelli ; Giuseppe Pietro Innocenti ; Eugenio Nelson Cavallari ; Luigi Celani ; Massimiliano Marazzato ; Francesco Alessandri ; Franco Ruberto ; Francesco Pugliese ; Mario Venditti ; Claudio M. Mastroianni ; Gabriella D'EttorreSource :
- Frontiers in nutrition [ 2296-861X ] ; 2020.
Abstract
Background: Mounting evidence suggests SARS-CoV-2 may impact on host microbiota and gut inflammation, infecting intestinal epithelial cells. This possible link and its implications can be investigated by observing the effects of modulation of the microbial flora in patients with COVID-19. The aim of this study was to compare the rate of mortality, the need of ICU hospitalization and the length of hospitalization in patients with severe COVID-19 pneumonia who received the best available therapy (BAT) vs. patients treated with BAT and supplemented with oral bacteriotherapy. Methods: This retrospective, observational cohort study included 200 adults with severe COVID-19 pneumonia. All patients received therapeutic regimens including low molecular weight heparin plus one or more between hydroxychloroquine, azithromycin, antivirals, and Tocilizumab. Oral bacteriotherapy was used as complementary treatment. Results: Out of the 200 patients, 112 received BAT without oral bacteriotherapy, and 88 BAT with oral bacteriotherapy. Crude mortality was 22%. Eleven percent died in the group of patients treated with BAT plus oral bacteriotherapy vs. 30% subjects in the group of patients managed only with BAT (p < 0.001). By multivariate analysis, the age >65 years, CRP >41.8 mg/L, Platelets <150.000 mmc, and cardiovascular events were associated with the increased risk of mortality. Oral bacteriotherapy was an independent variable associated with a reduced risk for death. Despite large prospective trials are needed, this study highlights a possible role for oral bacteriotherapy in the management of patients hospitalized for COVID-19 pneumonia.
DOI: 10.3389/fnut.2020.613928
PubMed: 33505983
PubMed Central: PMC7829198
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Oral Bacteriotherapy in Patients With COVID-19: A Retrospective Cohort Study.</title><author><name sortKey="Ceccarelli, Giancarlo" sort="Ceccarelli, Giancarlo" uniqKey="Ceccarelli G" first="Giancarlo" last="Ceccarelli">Giancarlo Ceccarelli</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Borrazzo, Cristian" sort="Borrazzo, Cristian" uniqKey="Borrazzo C" first="Cristian" last="Borrazzo">Cristian Borrazzo</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Medical Statistics Unit, Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pinacchio, Claudia" sort="Pinacchio, Claudia" uniqKey="Pinacchio C" first="Claudia" last="Pinacchio">Claudia Pinacchio</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Santinelli, Letizia" sort="Santinelli, Letizia" uniqKey="Santinelli L" first="Letizia" last="Santinelli">Letizia Santinelli</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Innocenti, Giuseppe Pietro" sort="Innocenti, Giuseppe Pietro" uniqKey="Innocenti G" first="Giuseppe Pietro" last="Innocenti">Giuseppe Pietro Innocenti</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Cavallari, Eugenio Nelson" sort="Cavallari, Eugenio Nelson" uniqKey="Cavallari E" first="Eugenio Nelson" last="Cavallari">Eugenio Nelson Cavallari</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Celani, Luigi" sort="Celani, Luigi" uniqKey="Celani L" first="Luigi" last="Celani">Luigi Celani</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Marazzato, Massimiliano" sort="Marazzato, Massimiliano" uniqKey="Marazzato M" first="Massimiliano" last="Marazzato">Massimiliano Marazzato</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Alessandri, Francesco" sort="Alessandri, Francesco" uniqKey="Alessandri F" first="Francesco" last="Alessandri">Francesco Alessandri</name><affiliation><nlm:affiliation>Department of Anaesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ruberto, Franco" sort="Ruberto, Franco" uniqKey="Ruberto F" first="Franco" last="Ruberto">Franco Ruberto</name><affiliation><nlm:affiliation>Department of Anaesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pugliese, Francesco" sort="Pugliese, Francesco" uniqKey="Pugliese F" first="Francesco" last="Pugliese">Francesco Pugliese</name><affiliation><nlm:affiliation>Department of Anaesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Venditti, Mario" sort="Venditti, Mario" uniqKey="Venditti M" first="Mario" last="Venditti">Mario Venditti</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mastroianni, Claudio M" sort="Mastroianni, Claudio M" uniqKey="Mastroianni C" first="Claudio M" last="Mastroianni">Claudio M. Mastroianni</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="D Ettorre, Gabriella" sort="D Ettorre, Gabriella" uniqKey="D Ettorre G" first="Gabriella" last="D'Ettorre">Gabriella D'Ettorre</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:33505983</idno><idno type="pmid">33505983</idno><idno type="doi">10.3389/fnut.2020.613928</idno><idno type="pmc">PMC7829198</idno><idno type="wicri:Area/Main/Corpus">000431</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000431</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Oral Bacteriotherapy in Patients With COVID-19: A Retrospective Cohort Study.</title><author><name sortKey="Ceccarelli, Giancarlo" sort="Ceccarelli, Giancarlo" uniqKey="Ceccarelli G" first="Giancarlo" last="Ceccarelli">Giancarlo Ceccarelli</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Borrazzo, Cristian" sort="Borrazzo, Cristian" uniqKey="Borrazzo C" first="Cristian" last="Borrazzo">Cristian Borrazzo</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Medical Statistics Unit, Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pinacchio, Claudia" sort="Pinacchio, Claudia" uniqKey="Pinacchio C" first="Claudia" last="Pinacchio">Claudia Pinacchio</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Santinelli, Letizia" sort="Santinelli, Letizia" uniqKey="Santinelli L" first="Letizia" last="Santinelli">Letizia Santinelli</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Innocenti, Giuseppe Pietro" sort="Innocenti, Giuseppe Pietro" uniqKey="Innocenti G" first="Giuseppe Pietro" last="Innocenti">Giuseppe Pietro Innocenti</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Cavallari, Eugenio Nelson" sort="Cavallari, Eugenio Nelson" uniqKey="Cavallari E" first="Eugenio Nelson" last="Cavallari">Eugenio Nelson Cavallari</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Celani, Luigi" sort="Celani, Luigi" uniqKey="Celani L" first="Luigi" last="Celani">Luigi Celani</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Marazzato, Massimiliano" sort="Marazzato, Massimiliano" uniqKey="Marazzato M" first="Massimiliano" last="Marazzato">Massimiliano Marazzato</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Alessandri, Francesco" sort="Alessandri, Francesco" uniqKey="Alessandri F" first="Francesco" last="Alessandri">Francesco Alessandri</name><affiliation><nlm:affiliation>Department of Anaesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ruberto, Franco" sort="Ruberto, Franco" uniqKey="Ruberto F" first="Franco" last="Ruberto">Franco Ruberto</name><affiliation><nlm:affiliation>Department of Anaesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pugliese, Francesco" sort="Pugliese, Francesco" uniqKey="Pugliese F" first="Francesco" last="Pugliese">Francesco Pugliese</name><affiliation><nlm:affiliation>Department of Anaesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Venditti, Mario" sort="Venditti, Mario" uniqKey="Venditti M" first="Mario" last="Venditti">Mario Venditti</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mastroianni, Claudio M" sort="Mastroianni, Claudio M" uniqKey="Mastroianni C" first="Claudio M" last="Mastroianni">Claudio M. Mastroianni</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="D Ettorre, Gabriella" sort="D Ettorre, Gabriella" uniqKey="D Ettorre G" first="Gabriella" last="D'Ettorre">Gabriella D'Ettorre</name><affiliation><nlm:affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Frontiers in nutrition</title><idno type="ISSN">2296-861X</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><b>Background:</b> Mounting evidence suggests SARS-CoV-2 may impact on host microbiota and gut inflammation, infecting intestinal epithelial cells. This possible link and its implications can be investigated by observing the effects of modulation of the microbial flora in patients with COVID-19. The aim of this study was to compare the rate of mortality, the need of ICU hospitalization and the length of hospitalization in patients with severe COVID-19 pneumonia who received the best available therapy (BAT) vs. patients treated with BAT and supplemented with oral bacteriotherapy. <b>Methods:</b> This retrospective, observational cohort study included 200 adults with severe COVID-19 pneumonia. All patients received therapeutic regimens including low molecular weight heparin plus one or more between hydroxychloroquine, azithromycin, antivirals, and Tocilizumab. Oral bacteriotherapy was used as complementary treatment. <b>Results:</b> Out of the 200 patients, 112 received BAT without oral bacteriotherapy, and 88 BAT with oral bacteriotherapy. Crude mortality was 22%. Eleven percent died in the group of patients treated with BAT plus oral bacteriotherapy vs. 30% subjects in the group of patients managed only with BAT (<i>p</i> < 0.001). By multivariate analysis, the age >65 years, CRP >41.8 mg/L, Platelets <150.000 mmc, and cardiovascular events were associated with the increased risk of mortality. Oral bacteriotherapy was an independent variable associated with a reduced risk for death. Despite large prospective trials are needed, this study highlights a possible role for oral bacteriotherapy in the management of patients hospitalized for COVID-19 pneumonia.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">33505983</PMID><DateRevised><Year>2021</Year><Month>01</Month><Day>30</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">2296-861X</ISSN><JournalIssue CitedMedium="Print"><Volume>7</Volume><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>Frontiers in nutrition</Title><ISOAbbreviation>Front Nutr</ISOAbbreviation></Journal><ArticleTitle>Oral Bacteriotherapy in Patients With COVID-19: A Retrospective Cohort Study.</ArticleTitle><Pagination><MedlinePgn>613928</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3389/fnut.2020.613928</ELocationID><Abstract><AbstractText><b>Background:</b> Mounting evidence suggests SARS-CoV-2 may impact on host microbiota and gut inflammation, infecting intestinal epithelial cells. This possible link and its implications can be investigated by observing the effects of modulation of the microbial flora in patients with COVID-19. The aim of this study was to compare the rate of mortality, the need of ICU hospitalization and the length of hospitalization in patients with severe COVID-19 pneumonia who received the best available therapy (BAT) vs. patients treated with BAT and supplemented with oral bacteriotherapy. <b>Methods:</b> This retrospective, observational cohort study included 200 adults with severe COVID-19 pneumonia. All patients received therapeutic regimens including low molecular weight heparin plus one or more between hydroxychloroquine, azithromycin, antivirals, and Tocilizumab. Oral bacteriotherapy was used as complementary treatment. <b>Results:</b> Out of the 200 patients, 112 received BAT without oral bacteriotherapy, and 88 BAT with oral bacteriotherapy. Crude mortality was 22%. Eleven percent died in the group of patients treated with BAT plus oral bacteriotherapy vs. 30% subjects in the group of patients managed only with BAT (<i>p</i> < 0.001). By multivariate analysis, the age >65 years, CRP >41.8 mg/L, Platelets <150.000 mmc, and cardiovascular events were associated with the increased risk of mortality. Oral bacteriotherapy was an independent variable associated with a reduced risk for death. Despite large prospective trials are needed, this study highlights a possible role for oral bacteriotherapy in the management of patients hospitalized for COVID-19 pneumonia.</AbstractText><CopyrightInformation>Copyright © 2021 Ceccarelli, Borrazzo, Pinacchio, Santinelli, Innocenti, Cavallari, Celani, Marazzato, Alessandri, Ruberto, Pugliese, Venditti, Mastroianni and d'Ettorre.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ceccarelli</LastName><ForeName>Giancarlo</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Borrazzo</LastName><ForeName>Cristian</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Medical Statistics Unit, Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pinacchio</LastName><ForeName>Claudia</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Santinelli</LastName><ForeName>Letizia</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Innocenti</LastName><ForeName>Giuseppe Pietro</ForeName><Initials>GP</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cavallari</LastName><ForeName>Eugenio Nelson</ForeName><Initials>EN</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Celani</LastName><ForeName>Luigi</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Marazzato</LastName><ForeName>Massimiliano</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alessandri</LastName><ForeName>Francesco</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Anaesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ruberto</LastName><ForeName>Franco</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Anaesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pugliese</LastName><ForeName>Francesco</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Anaesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Venditti</LastName><ForeName>Mario</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mastroianni</LastName><ForeName>Claudio M</ForeName><Initials>CM</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>d'Ettorre</LastName><ForeName>Gabriella</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>01</Month><Day>11</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Front Nutr</MedlineTA><NlmUniqueID>101642264</NlmUniqueID><ISSNLinking>2296-861X</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">gut</Keyword><Keyword MajorTopicYN="N">microbiota</Keyword><Keyword MajorTopicYN="N">oral bacteriotherapy</Keyword><Keyword MajorTopicYN="N">pneumonia</Keyword></KeywordList><CoiStatement>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>10</Month><Day>04</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>12</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>1</Month><Day>28</Day><Hour>5</Hour><Minute>44</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>1</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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