Efficiency of application of sorbed probiotics in complex therapy of pneumonia caused by SARS-CoV-2. Part 1. Heating clinical displays period

Aim. To determine the clinical efficacy and safety of the sorbed probiotics Bifidobacterium bifidum 1 (5×10⁸ KОЕ) and B. bifidum 1 (5×10⁷ KОЕ) in combination with Lactobacillus plantarum 8P-А3 in the complex therapy of pneumonia caused by SARS-CoV-2 in adult patients without severe risk factors.

Materials and methods. An open, randomized prospective study included 100 patients (45 men, 55 women), aged 18 to 60 years without risk factors for severe COVID-19 with pneumonia confirmed by computed tomography, and an area of lung lesion no more than 75% (moderate forms). SARS-CoV-2 RNA in nasal and oropharyngeal swabs (RT-PCR) was detected in 72% of the participants, in the rest it was highly probable in terms of the aggregate parameters. Diagnostics of COVID-19 and its severity, the appointment of a standard examination and treatment were carried out in accordance with the Temporary Methodological Recommendations of the Ministry of Health of Russia, version 8 of 09.03.2020. This publication presents the results of using B. bifidum 1 (3 capsules twice a day for 10 days) during the peak of clinical manifestations (in a hospital).

Results. In those who received sorbed B. bifidum 1, by the 10th day of treatment, the frequency of weakness was 32% lower (RR 0.55 [95% CI 0.24–0.73], OR 0.25 [0.11–0.59]); hypoosmia/dysgeusia – by 22% (RR 0.42 [0.05–0.65], OR 0.40 [0.17–0.90]) and cough – by 24% (RR 0.39 [0.07–0.60], OR 0.38 [0.17–0.84]). B. bifidum 1 reduced the average duration of weakness by 3 days [1.1–4.9], hypoosmia/dysgeusia by 3.2 days [1.3–5.1], cough by 1.9 days [0.4–3,4], dyspnea – by 1.8 days [0.7–2.7], diarrhea – by 1.7 days [0.1–3.5]; reduced the risk of antibiotic-associated diarrhea by 20% (RR 0.77 [0.24–0.93], OR 0.18 [0.05–0.68]). Due to the deterioration of the condition and the increase in the symptoms of respiratory failure, additional treatment was required less often by 24% (p=0.005). After the end of the intervention, the frequency of virologic debridement, levels of CRP, leukocytes, lymphocytes, platelets and the degree of lung damage on computed tomography did not statistically differ in the compared groups. No side effects of B. bifidum 1 (5×10⁸ KОЕ) have been identified.

Conclusion. The use of sorbed B. bifidum 1 (5×10⁸ KОЕ) improved the well-being of patients without risk factors with moderate viral (SARS-CoV-2) pneumonia and reduced the duration of diarrheal syndrome in a short time. The safety profile of their use was high. More research is needed to clarify the anti-inflammatory effects of the sorbed probiotic.