The fungi in our guts can make cases of Covid worse
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Do these effects happen when people get severe flu as well, or other viruses? Also, were the control patients hospitalized for other reasons, or not in the hospital at all? Hospital-Acquired Infections are a thing, it would be good to understand if being hospitalized played a role here as well.
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ColdWetDog
Ars Legatus Legionis
Interesting. The presence of fungal 'co infections' (poorly defined, anything from 'we found some on this test' to massive invasive fungal disease) has been a known issue in COVID 19 infections since the early days.
Unfortunately, basically empiric treatment with antifungals has not clearly been identified as helping outcomes although most of the research has been done in the acute setting so long COVID treatment with antifungals is still an open question.
Likewise IL-6 antagonists have not yielded positive results either in prophylaxis or treatment.
An open question* is the role of concomitant steroids - which is near universal in severe COVID treatment especially in the early days (when the patients were selected). The Nature article didn't specifically control for either steroid or antibiotic use although they did a general 'ICU patient' control which would likely include both drugs. Unfortunately, sample sizes are too small to expect sub analyses to be meaningful.
So the easy pharmaceutical answers to the problem likely won't work. Back to work!
* in terms of the nature of the immune and fungal population responses.
Unfortunately, basically empiric treatment with antifungals has not clearly been identified as helping outcomes although most of the research has been done in the acute setting so long COVID treatment with antifungals is still an open question.
Likewise IL-6 antagonists have not yielded positive results either in prophylaxis or treatment.
An open question* is the role of concomitant steroids - which is near universal in severe COVID treatment especially in the early days (when the patients were selected). The Nature article didn't specifically control for either steroid or antibiotic use although they did a general 'ICU patient' control which would likely include both drugs. Unfortunately, sample sizes are too small to expect sub analyses to be meaningful.
So the easy pharmaceutical answers to the problem likely won't work. Back to work!
* in terms of the nature of the immune and fungal population responses.
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ColdWetDog
Ars Legatus Legionis
This was a rather limited study of just COVID and done early on in the pandemic where treatment strategies varied widely. There just aren't the numbers to do it otherwise and there was an enormous amount of bench work done just to get these results.
As usual, 'Reply hazy, ask again later.'
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All sorts of things can change the balance of your gut microbiome. Any kind of general infection, antibiotics, changing your diet, stress, etc.
It's a wild and super important world in our guts, and we know very little about it with reasonable certainty other than some pretty basic things.
Diversity of species is important. How diverse? Which ones? - I'll go with the abovementioned "reply hazy, ask again later."
Eating enough fiber/plant material is important. How much? What kinds are better, or do you ideally want a mix of fibers within a certain range? How fixable is this? Is a supplement just as good as eating some cabbage?
Antibiotics fuck up the balance of species. What's the correct balance? How do you get back to it without resorting to a fecal transplant? How do we minimize the damage?
If you're interested, there's a whole fecal transplant rabbit hole of Ars articles to go through. Mostly Beth, of course - plus Dr. Gitlin writing about his cats.
https://meincmagazine.com/tag/fecal-transplant/
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ColdWetDog
Ars Legatus Legionis
I, for one, am really confused about our bacterial and fungal overlords.
I thought it was supposed to be the mice.
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Interesting… Coeliac disease cause cytokine storms that indiscriminately destroy healthy gut tissue and organs. Celiacs test positive for one of two genes DQ2, DQ8 or both.
Until today gene therapy seemed appropriate but here modulating interluken is signaling colonies in the gut.
Do triggered genes DQ2/DQ8 use interluken transport in the body?
Until today gene therapy seemed appropriate but here modulating interluken is signaling colonies in the gut.
Do triggered genes DQ2/DQ8 use interluken transport in the body?
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I was also wondering something similar, if the resistance they developed to the fungi contributed to the cytokine storms that caused severe responses to covid
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The question "What's normal?" isn't the whole question. The question should be "What's nominal for this individual?"
That's the elephant in the room no one can answer. The problem often lies with modern medicine's tendency to average things. Everyone get a specific dose of a particular medication, regardless of health (effecting metabolism and metabolic functions), gender, weight and a host of other factors that, for the "average human" would be sufficient and beneficial.
But the "average human" is a tiny minority of actual living, breathing people.
Because of this, the whole concept of "everyone is unique and must be treated as a unique individual" is alien to modern medicine. It tries using unique combinations of remedies that have been dosed for the average human being, which may or may not prove effective for the individual.
With gut biome, this issue is exponentially worse. There is no certainty that what works for "the average human being" will work for the individual (unless that individual is an "average human being", and even then, most medications might be beneficial, or might not be). There's just too much work left in figuring out how it impacts people and what's best for a specific individual.
It's certainly not beyond our ability to do that, but I don't see a lot of certainty happening yet in the way remedies are applied to be of any actual benefit to any individual. It's still very much miss, with very few hits. So gut biome health is still a huge work in progress to get right.
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If we were cellular democracies, we would be outvoted >99:1 by our microbial passengers. With generations which can be under an hour, they tend to have memories which make goldfish look like savants, so their decisions might appear inconsistent on our time scale, even if they only held one vote each generation.
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About 90% of pancreatic cancers contain mutant KRAS, so one will need an MOA which explains how fungi produce that selective DNA damage.
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A related personal anecdote has left me really wanting to do lab research on this, because we know so little about the gut microbiome. As a kid, I was dairy intolerant, but mostly grew out of it by my teens. Last fall I got COVID, and after I recovered I was again diary intolerant. Cow dairy was by far worse than others, but even goat or sheep milk cheese also caused a small reaction. Then six weeks ago I had major surgery and spent 5 days in the hospital on heavy IV antibiotics followed by a round of oral cipro when I came home. I noticed the goat and sheep milk cheeses no longer caused any reaction and decided to try cow milk cheese and found it was fine too. Even cream is fine now which before surgery would have led to instant issues that would then last for a day or two. So the major reset of my microbiome seems to have reversed the COVID induced dairy intolerance, and damn do I want to know the exact mechanism for both the original intolerance and the sudden reversal of it.
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Historically the weekend Wired articles had a consistently lower quality than the inhouse articles. Nothing to do with politics, just accuracy and technical depth.
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I think that “early on” is a pretty big caveat. More recent research shows that there‘s no long term difference between the ordinary flu and COVID (in fact, effects from COVID are slightly less prevalent), so that may well affect the studies of this issue as well.
“The results of the study, which Gerrard will present next month at the European Congress of Clinical Microbiology and Infectious Diseases in Barcelona, found no evidence that those who had Covid-19 were more likely to have functional limitations a year on compared with those who did not have Covid-19 (3.0% v 4.1%).”
“long Covid may have appeared to be a distinct and severe illness because of the high number of people infected with Covid-19 within a short period of time, rather than the severity of long Covid symptoms.”
https://www.theguardian.com/society/2024/mar/15/long-covid-symptoms-flu-cold
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It sounds a lot more sinister when you call it "fungi" and talk about the dangers of the fungal loads instead of just calling it yeast.
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On the flip side, "just calling it yeast" may be underplaying it a bit.
https://en.wikipedia.org/wiki/Candida_albicans
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ColdWetDog
Ars Legatus Legionis
That study really isn't germane to this discussion. It has been clear that some people are badly affected by viral illnesses that most other patients clear in a couple of weeks and that 'long' syndrome is irrespective of any other preexisting condition. In fact, most of the 'long' viral syndrome were healthy and relatively young.
COVID does it, others do it. That study said that COVID and influenza did it at approximately the same rate. That really doesn't say anything about the mechanisms - which this study is trying to get at.
In a sense, the authors of the article you cite are correct. It should be called 'Post Viral Syndrome' or something to that effect. Currently it seems to be what 'Chronic Fatigue Syndrome' and variants are all about but the data isn't particularly clear on that. But TFA just studied COVID patients because they are convenient in that they have a defined illness and then Something Happened.
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Fungus on the sinister, yeast on the right, here I am stuck in the middle with long COVID.
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I knew we had gut bacteria, but I had no idea that we had fungi as part of our gut biome as well, or that our bodies had specific antibodies to fight off fungal infections way it fights bacteria/viruses.
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I haven't read an article about it yet, but I heard the other day that scientists were beginning to suspect that long-flu might be a thing. It'll be interesting to see what we start learning now that we have an idea of what to look for.
Edited for spelling.
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Yep. Pretty interesting.
I learned about it the hard way...having had a serious case of valley fever about a decade ago. Infectious disease specialist said it may have been fatal if not for the miracle of Fluconazole , which I was on for nearly a year.
And yes, gut was jacked up a good period of that year...and ever since. No idea if the changes were from fungus, immune response, anti-fungal, all the above, or something else.
Tons of info out there about valley fever (medical name coccidioidomycosis or “cocci” for short) and other mold exposure immune response, which while it starts in the lungs, gets in the blood stream and can land anywhere in the body (joints, spine and brain are common). From this info I would expect body-wide immune response infor could be related/relevant to this article.
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Moas are already very large, terrifying flightless birds. Please don't expand them.
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My story is that I had to take three different antibiotics in four months for different issues. My doctor recommended the OTC Florastor. It helped tremendously, although I could tell that my digestion was "different" than it had been before. Specifically, I had to re-teach my gut to react kindly to beans (pulses, not the green ones). Over time I became myself again. I appreciated Ed Yong's book I Contain Multitudes.
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You can be at the beginning of a great learning journey. Just as some skin infections are bacterial, and respond to treatments such as topical antibiotics, others are fungal, such as athlete's foot or ringworm (which, confusingly isn't a worm at all) and respond to antifungals, usually labeled in the pharmacy section as for athlete's foot. Other species of these and many other life forms live in our gut. For more on this I recommend I Contain Multitudes by Ed Yong. He wrote that book when epigenenetics was all the rage and I was surprised he picked this for his topic. But he was right on track. How much do we hear about epigenetics any more?
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And quite unlikely inhabitants of pancreatic cancers, given that they are not only as you describe, but extinct.
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