Probiotics in prevention and treatment of COVID-19: a systematic review of current evidence

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Abstract

Introduction. Clinical evidence suggests that certain probiotics may help treat and prevent viral infections. To date, the effectiveness of probiotics in the alleviation of COVID-19 has not been established. The aim of this systematic review was to assess the role of probiotics in the prevention and treatment of COVID-19.

Materials and methods. An extensive search of four electronic databases was performed which included Embase, Scopus, Web of Science, and PubMed from November 2019 to June 2022. After reviewing the references list of related articles additional studies were identified. A multiple combination of keywords validated by MESH were used to search the databases. Study selection was performed according to an inclusion and exclusion criteria.

Results. Twenty-three articles met the study inclusion criteria. Six articles were conducted in vitro while the remaining studies were conducted in the human population (in vivo). The type of probiotic was defined in eighteen studies. There were two studies that used supplements (vitamins, herbals, minerals, etc.) in addition to probiotics. The largest sample size was 445 850 participants which were from a study that used an application-based survey. The majority of studies found that probiotics had a positive effect on the COVID-19 disease. The benefits included early remission of COVID-19 symptoms and a shorter duration of sickness (10 studies), lower mortality rates (3 studies), and decreased hospitalization and length of stay (3 studies). Six in vitro studies found that probiotics were beneficial against SARS-CoV-2 through antiviral effects. There were only two studies that found probiotics to be ineffective or caused negative effects when consumed in COVID-19 patients.

Conclusion. Available evidence supports the antiviral role of probiotics on prevention and treatment of COVID-19. The antiviral potential of Lactobacillus paracasei metabolite PlnE and PlnF against SARS-CoV-2 may explain the effectiveness of probiotics on COVID-19.

About the authors

S. SeyedAlinaghi

Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences

Email: s_a_alinaghi@yahoo.com

MD, MPhil, PhD, Clinical Epidemiologist, Associate Professor, Research Deputy of Iranian Research Center for HIV/AIDS (IRCHA)

Iran, Islamic Republic of, Tehran

Ramin Shahidi

School of Medicine, Bushehr University of Medical Sciences

Email: dr.raminshahidi1@gmail.com

MD, School of Medicine

Iran, Islamic Republic of, Bushehr

Arian Afzalian

School of Medicine, Tehran University of Medical Sciences

Email: Arianafzalian@gmail.com

MD, School of Medicine

Iran, Islamic Republic of, Tehran

Parinaz Paranjkhoo

Turpanjian College of Health Sciences, American University of Armenia

Email: parinazparanjkhoo@gmail.com

MD, MPH, Researcher Turpanjian College of Health Sciences

Armenia, Yerevan

Kobra Ghorbanzadeh

Khalkhal University of Medical Sciences

Email: ghorbanzadec@gmail.com

PhD (Nursing), Department of Nursing, Department of Health Information Technology

Iran, Islamic Republic of, 5681761351, Khalkhal

Hengameh Mojdeganlou

The Johns Hopkins University

Email: Hmojdeg1@jhmi.edu

MD, School of Medicine, Department of Pathology

United States, Baltimore

Armin Razi

School of Medicine, Tehran University of Medical Sciences

Email: armin.razy@gmail.com

MD, Internal Medicine Department

Iran, Islamic Republic of, Tehran

Paniz Mojdeganlou

Shahid Beheshti University of Medical Sciences

Email: Paniz.Mojdeganlou@gmail.com

MD

Iran, Islamic Republic of, Tehran

Mohsen Dashti

Tabriz University of Medical Sciences

Email: Mohsen.d4shti@gmail.com

MD, Department of Radiology

Iran, Islamic Republic of, Tabriz

Afsaneh Ghasemzadeh

Tabriz University of Medical Sciences Iran

Email: Afsanemqsz1996@gmail.com

MD, Department of radiology

Iran, Islamic Republic of, Tabriz

Sahar N. Parikhani

School of Medicine, Tehran University of Medical Sciences

Email: Sahar.nurse91@gmail.com

BS in Nursing, School of Medicine

Iran, Islamic Republic of, Tehran

A. Pashaei

University of British Columbia

Email: zahra.pashaei243@gmail.com

PhD Student, School of Nursing

Canada, Vancouver

Amirali Karimi

School of Medicine, Tehran University of Medical Sciences

Email: karimi.amirali.1999@gmail.com

MD, School of Medicine

Iran, Islamic Republic of, Tehran

Ahmadi Sepide

School of Medicine, Tehran University of Medical Sciences

Email: Sepide2434@gmail.com

MD, School of Medicine 

Iran, Islamic Republic of, Tehran

Esmaeil Mehraeen

Khalkhal University of Medical Sciences

Email: es.mehraeen@gmail.com

PhD, Assistant Professor, Department of Health Information Technology

Iran, Islamic Republic of, 5681761351, Khalkhal

Daniel Hackett

The University of Sydney

Author for correspondence.
Email: daniel.hackett@sydney.edu.au

PhD (Exercise and Sport Science), Lecturer in Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health

Australia, Sydney, New South Wales

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