This document discusses the link between gut microbiota and COVID-19. It explains that a healthy gut microbiota with high diversity is important for immune function. Factors like age, diet, antibiotics, and preexisting conditions can cause gut dysbiosis. Dysbiosis is linked to increased COVID-19 severity and worse outcomes. Maintaining gut health through a fiber-rich diet with prebiotics and probiotics can support the microbiota and boost immunity against COVID-19. Nutritional strategies are important given the lack of pharmacological prevention or treatment currently.

3. Dr. C.SHEELA SASIKUMAR
HEAD - CLINICAL RESEARCH
HYCARE SUPER SPECIALITY HOSPITAL
CHENNAI
Mob: 9283143681
E mail: sheelsasic@yahoo.co.in

4. FOR MORE INFORMATION PLEASE FOLLOW MY
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5. ALL DISEASES BEGIN IN THE GUT
GREEK PHYSICIAN HIPPOCRATES
FATHER OF MODERN MEDICINE

6. Your Immune System is
Your vaccine today

7. A healthy gut will strengthen
your immune system.

8. Boosting immunity through food is
essential with the ongoing global
pandemic.

9. “Everything is alive, everything is
interconnected.”
[–Cicero 106BCE]

10. Our gut interacts with the
environment- positive interactions
absorption of food and negative
interactions Defense against
pathogens
A healthy microbiome improves the
absorbance of nutrients from good
foods.

11. We are entering an era where we can
increasingly modify health through
food and measure the effects through
our microbes or metabolites.
 “Food as medicine” has been a powerful
approach to health and healing from ancient times

12. What is a microbiome ?
 The human body including the gut, skin
and other mucosal environments, is
colonized by a tremendous number of
microorganisms collectively termed the
microbiome
 More than 100 trillion
symbiotic microorganisms live on and
within human beings and play an
important role in human health and
disease

13.  Human gut microbiota consists of 1014 resident
microorganisms which include bacteria, archae, viruses and
fungi
 In healthy individuals is dominated by four
phyla Actinobacteria, Firmicutes, Proteobacteria, and
Bacteroidetes
 Plays a key role in health through its protective, trophic and
metabolic actions.
 Colon harbours an extremely high density of bacteria in the
families Bacteroidaceae, Prevotellaceae, Rikenellaceae,
Lachnospiraceae and Ruminococcaceae

14. Gut microbiota, has even been considered to be an
“essential organ” carrying approximately 150 times
more genes than are found in the entire human genome
Commensal bacteria colonize the host shortly after
birth gradually develops into a highly diverse
ecosystem during host growth
Host-bacterial associations have developed into
beneficial relationships

15. Factors that influence the microbiota
 In utero the human being does not have a
microbiota
 Upon birth the gastrointestinal tract colonizes
immediately
 We inherit our gut flora from our mother
 Composition -determined and influenced by a
number of endogenous and exogenous factors
geographic origin, age, genetics, diet and the use
of prebiotics and antibiotics.

16. GUT
MICROBIOTA
METABOLISM
Biosynthesis, Production of
metabolites
STRUCTURAL
Cell growth and
differentiation
Cell and Tissue development
PROTECTIVE
Protection against pathogens
Activation of Immune system
FUNCTIONS

17. Intestinal microbiota in health
 Metabolize indigestible compounds
 supply essential nutrients
 defend against colonization by opportunistic pathogens
 contribute to the formation of intestinal architecture
 Involved in the digestion of certain foods that cannot be
digested by the stomach and small intestine. Eg dietary fibers
found in vegetables

18.  to deliver vitamins to the host
 Folates
 vitamin K
 biotin
 riboflavin (B2)
 cobalamin (B12)
 other B vitamins
 Produces short-chain fatty acids (SCFAs) acetic, propionic, and
butyric acids, and serves as an energy source to the host intestinal
epithelium
 stimulate the normal development of the humoral and cellular
mucosal immune systems

19. train the immune system,
 prevent the growth of pathogenic bacteria,
 regulate the gut development
maintain epithelial integrity - by regulating tight junction
permeability. Lactobacillus plantarum was reported to regulate
tight-junction proteins to protect against chemical-induced
disruption of the epithelial barrier

20. Loss of gut epithelial integrity will allow gut bacteria
bacterial toxins incompletely digested fats and proteins,
and wastes to pass the epithelium into the blood stream
 Trigger inflammatory responses and leading to
gastrointestinal problems such as abdominal bloating,
excessive gas and cramps and food sensitivities
Gut bacteria play an important role in the development
of white blood cells that help the body's immune
system fight infection

21.  regulating gut motility
 shape the neuronal development
 essential for normal CNS development
 affect a variety of complex behaviours including social,
emotional and anxiety-like behaviours
 contribute to brain development and function

22. Gut-Where Bacteria and
Immune System Meet

23. IMMUNITY GUT
MICROBIOTA
Help to grow healthy microbes and maintain a gut
environment
Development of immune cells and contribute to Immune
response

24. GUT MICROBIOTA AS POTENTIAL INDUCER OF INNATE
MEMORY.
https://www.frontiersin.org/articles/10.3389/fimmu.20
19.02441/full

25. https://www.nature.com/articles/s41422-020-0332-7.pdf

26. Schematic representation of the role of the gut microbiota in health and disease giving some
examples of inputs and outputs.
Ana M Valdes et al. BMJ 2018;361:bmj.k2179
©2018 by British Medical Journal Publishing Group

27. Microbiota Protects Against Allergic Inflammation

30. Gut microbiota and
Covid-19 - possible link

31.  Despite strategies based on social distancing, hygiene, and
screening COVID-19 is progressing rapidly throughout the
world with healthcare systems at risk of being overwhelmed
 Presents with a spectrum of disease severity, ranging from mild
and non-specific flu-like symptoms to pneumonia, and life-
threatening complications such as ARDS and multiple organ
failure.
 Transmission occur mainly via respiratory droplets but the gut
may also contribute toward the pathogenesis of COVID-19
 Detected in the gastrointestinal tract and stool samples from
patients and in sewage systems

32.  Gut microbiota diversity and the presence of beneficial
microorganisms in the gut may play an important role in
determining the course of this disease.
 Old aged, immune-compromised patients and patients with
other co-morbidities like type-2 diabetes, cardiovascular
disorders fare poorly in combating Covid-19.
 General imbalance of gut microbiota called “dysbiosis” is
implicated in such patients and the elderly.

33. https://dx.doi.org/10.1016%2Fj.virusres.2020.198018
Possible role of the gut microbiota in
modulating immune response in Covid-19.

34. (SARS-CoV2) infects ACE2
expressing epithelial cells in the
lung and/or the intestine. This is
followed by production of
mediators causing immune cell
activation. Overwhelming
immune cell activation may lead
to severe complications including
acute respiratory distress
syndrome (ARDS), shock and
kidney or multiorgan failure. B,
B lymphocytes; IEC, intestinal
epithelial cell; ILC, innate
lymphoid cell; M,
monocyte/macrophage; N,
neutrophils; Teff, effector T cells;
Treg, regulatory T cell; Type I P,
type I pneumocytes; Type II P,
type II pneumocy
Hypothetical pathogenesis of COVID-19
doi:10.1136/gutjnl-2020-321269

35. https://www.expresshealthcare.in/amp/clinical-
research/gut-microbiota-and-covid-19-possible-link-and-
implications/420733/
The basis of these studies
Gut microbiota link to COVID-19
 The first one was the presence of the SARS-Cov2 viral RNA
or even live virus in the faeces of many of the affected
patients.
 Secondly, the various gastrointestinal symptoms in many
patients
 Thirdly the fact that the most vulnerable were the elderly,
immune-compromised patients and patients with other co-
morbidities.
 In all such people, gut dysbiosis and decreased gut diversity
(especially in the elderly) have been observed.

36.  A healthy gut microbiome essentially could be
fundamental in maintaining an optimal immune system to
prevent an array of excessive immune reactions that
eventually become detrimental to lungs and vital organ
systems
The composition of balanced gut microbiota is known to
have a major influence on the effectiveness of lung
immunity

37. A healthy microbiome is a diverse
microbiome containing many different
species and each organism play a vital role in
immunity …… And as age increases there is
a decline in the microbiome diversity
which explains the decrease in immunity as
age progresses

38. Diet and other
environmental
factors influence
gastrointestinal
Microbiota (GI)
homeostasis or
dysbiosis.

39. BALANCED DIET

40. Dietary Fiber –Roughage

41.  Diet plays an important role in shaping the composition of the
gut microbiota thereby influencing the host’s health status
 Fibre -good source of microbiota accessible carbohydrates
which provide the host with energy and improves intestinal
health
Indigestible portion of food derived from Plant
Soluble dietary fiber-Slow the movement of food in the
digestive system eg Oats ,peas ,beans ,citrus fruits
Insoluble dietary fiber- accelerate the movement of thru
digestive system eg green leafy vegetables ,cabbage

42. Fiber and the Immune System
Whole fresh fruits and vegetables promote a healthy
gastrointestinal system.
 Fermented by the friendly bacteria in your colon to short-
chain fatty acids (SCFAs),
 SCFA are used as a fuel by gastrointestinal tract cells.
Promotes the removal of toxins that can adversely affect
your gastrointestinal tract cells
supports healthy digestive function overall.

43. PREBIOTICS

44. What are Prebiotics?
 Prebiotics are specialized plant fibers
 stimulate the growth of healthy bacteria in the gut
 found in many fruits and vegetables, especially those that
contain complex carbohydrates, such as fiber and resistant
starch.
 Not digestible by our body pass through the digestive system
 become food for the bacteria and other microbes.

45. PROBIOTICS

46. What are Probiotics ?
 live organisms usually specific strains of bacteria that
directly add to the population of healthy microbes in your
gut
 most common probiotic food is yogurt
 Yogurt is made by fermenting milk with different bacteria
which are left in the final product.
 Fermented Indian foods –Idly, Dosa, Vada , Dhokla

47. Maintain a healthy microbiome to fight COVID-19
.
How can you achieve?
The answer is simple but we need to practice
 eat nutritious food to feed your microbiome
 Eating plant-based food that you cook yourself
 limiting ultra-processed and take-away foods
 supplementing your diet with natural probiotics
Enhance your microbiome not just for COVID-19but for
your long-term health as well.

48. How can I boost healthy gut ?
 Take High-fiber foods
 Eat a wide range of plant-based foods
 Prebiotic-Rich Foods like onions, garlic, asparagus, whole
wheat, spinach, beans, bananas, oats
Fruit, vegetables, pulses, nuts and wholegrains feed healthy
bacteria
Avoid highly processed foods.

49. Probiotic-Rich Foods like live yoghurt, might
encourage more microbes to grow.
Eat less sugar and sweeteners
Follow Healthy Lifestyle.
 Exercise
 Enough sleep
 Manage stress-negatively impacts on physical, mental,
and even gut health.

52. Improving gut microbiota profile by
personalized nutrition and
supplementation known to improve
immunity can be one of the prophylactic
ways by which the impact of this disease
can be minimized in old people and
immune-compromised patients.
Gut microbiota and Covid-19- possible link and
implications
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217790/

53. Effective nutritional strategy
and specific functional foods
aiming at the microbiota for
specific population group may
be the need of the hour.

54. Taking care of our gut health and
especially nurturing a highly diverse
microbiota through a dietary intake rich
in a wide range of plant sources, fruits,
vegetables, grains and nuts will favor a
robust immune system and indirectly
increase our ability to fight viral attacks
in every organ including the lungs

55. HBOT- HYCARE SUPER SPECIALITY HOSPITAL

57. For a viral disease like COVID-19,
where no pharmacological
strategies for prevention or
treatment are presently available
and where the exact time of the
ending of the alarming situation is
unknown, nutritional strategies for
enhancing immunity is something to
be explored.

58. THANK YOU
LET US BOOST OUR IMMUNE
SYSTEM
S.S. HEALTHCARE
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