Efficacy of a Probiotic Consisting of Lacticaseibacillus rhamnosus PDV 1705, Bifidobacterium bifidum PDV 0903, Bifidobacterium longum subsp. infantis PDV 1911, and Bifidobacterium longum subsp. longum PDV 2301 in the Treatment of Hospitalized Patients with COVID-19: a Randomized Controlled Trial

Vladimir Ivashkin, Victor Fomin, Sergey Moiseev, Michail Brovko, Roman Maslennikov, Anatoly Ulyanin, Victoria Sholomova, Maria Vasilyeva, Elizaveta Trush, Oleg Shifrin, Elena Poluektova, Vladimir Ivashkin, Victor Fomin, Sergey Moiseev, Michail Brovko, Roman Maslennikov, Anatoly Ulyanin, Victoria Sholomova, Maria Vasilyeva, Elizaveta Trush, Oleg Shifrin, Elena Poluektova

Abstract

The treatment of coronavirus disease (COVID-19) and COVID-19-associated diarrhea remains challenging. This study aimed to evaluate the efficacy of a multi-strain probiotic in the treatment of COVID-19. This was a randomized, controlled, single-center, open-label trial (NCT04854941). Inpatients with confirmed COVID-19 and pneumonia were randomly assigned to a group that received a multi-strain probiotic (PRO group) or to the control group (CON group). There were 99 and 101 patients in the PRO and CON groups, respectively. No significant differences in mortality, total duration of disease and hospital stay, incidence of intensive care unit admission, need for mechanical ventilation or oxygen support, liver injury development, and changes in inflammatory biomarker levels were observed between the PRO and CON groups among all included patients as well as among subgroups delineated based on age younger or older than 65 years, and subgroups with chronic cardiovascular diseases and diabetes. Diarrhea on admission was observed in 11.5% of patients; it resolved earlier in the PRO group than in the CON group (2 [1-4] vs. 4 [3-6] days; p = 0.049). Hospital-acquired diarrhea developed less frequently in the PRO group than in the CON group among patients who received a single antibiotic (0% vs. 12.5%; p = 0.023) unlike among those who received > 1 antibiotic (10.5% vs. 13.3%; p = 0.696). The studied probiotic had no significant effect on mortality and changes in most biomarkers in COVID-19. However, it was effective in treating diarrhea associated with COVID-19 and in preventing hospital-acquired diarrhea in patients who received a single antibiotic.

Keywords: COVID-19; Diarrhea; Liver; Mortality; Probiotics.

Conflict of interest statement

The authors declare no competing interests.

© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Figures

Fig. 1
Fig. 1
CONSORT 2010 flow diagram
Fig. 2
Fig. 2
Survival curves for patients with coronavirus disease (COVID-19) who received the probiotic (dotted line) and those who did not (control group) (solid line): (a) all patients, (b) patients with cardiovascular diseases, and (c) patients with diabetes mellitus

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