Correction of intestinal microbial composition disturbances as a potential link in complex therapy of patients with COVID-19

The current state of the problem of intestinal microbiota according to pediatricians

The mechanisms of formation of the intestinal microbiota, its influence on the health of the child, participation in physiological and pathological processes are considered. Microorganisms enter the body of the fetus in utero, then the newborn child receives the microflora from the mother during childbirth. The results of molecular genetic studies indicate that the process of microbial colonization of a child is determined by the characteristics of nutrition. Of great importance in the formation of normal microflora belongs to breastfeeding. The gut microbiota interacts with various parts of the body, influencing the pathogenesis of many local and systemic diseases. The most important mechanisms for the formation of diseases in children depending on anomalies in the structure of the microbiome are considered. Understanding the processes of formation of intestinal microflora allows us to develop effective methods for the prevention and correction of microecological and motor disorders in the age aspect.

Features of the intestine conditions at patients with a new coronavirus infection

COVID-19 infection may present with gastrointestinal lesions in up to 25% of patients. One of the target organs of the SARS-CoV-2 virus is the intestine. The pathogenesis of intestinal damage in a new coronavirus infection remains unclear and requires further in-depth study. Possible mechanisms include a direct cytotoxic effect of the virus, a persistent reduction in butyrate-producing bacteria, side effects of drugs, Clostridioides difficile infection, microvascular thrombosis, and the immune-mediated inflammatory reactions in the intestine. The most common symptom of intestinal damage during coronavirus infection, both in the acute phase and in the post-COVID period, is diarrhea. The impact of many aggressive factors on the intestines can form both long-term functional disorders and be the cause of the onset of organic diseases. Treatment should be aimed at possible causes of intestinal damage (Clostridioides difficile), as well as reducing inflammation, restoring intestinal permeability, cytoprotection of mucosal cells, replenishing butyric acid deficiency. When choosing a therapy for intestinal disorders, preference should be given to drugs with a pleiotropic effect in order to influence various possible pathogenetic mechanisms.