The gut microbiome as a biomarker of differential susceptibility to SARS-CoV-2

Amar Sarkar, Siobhán Harty, Andrew H. Moeller, Sabra L. Klein, Susan E. Erdman, Karl J. Friston, Rachel N. Carmody

Research output: Contribution to journalReview articlepeer-review

31 Scopus citations


Coronavirus disease 2019 (COVID-19) continues to exact a devastating global toll. Ascertaining the factors underlying differential susceptibility and prognosis following viral exposure is critical to improving public health responses. We propose that gut microbes may contribute to variation in COVID-19 outcomes. We synthesise evidence for gut microbial contributions to immunity and inflammation, and associations with demographic factors affecting disease severity. We suggest mechanisms potentially underlying microbially mediated differential susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). These include gut microbiome-mediated priming of host inflammatory responses and regulation of endocrine signalling, with consequences for the cellular features exploited by SARS-CoV-2 virions. We argue that considering gut microbiome-mediated mechanisms may offer a lens for appreciating differential susceptibility to SARS-CoV-2, potentially contributing to clinical and epidemiological approaches to understanding and managing COVID-19.

Original languageEnglish (US)
Pages (from-to)1115-1134
Number of pages20
JournalTrends in Molecular Medicine
Issue number12
StatePublished - Dec 2021
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Molecular Medicine
  • Molecular Biology


  • COVID-19
  • immunity
  • immunological dark matter
  • inflammation
  • microbiota
  • modelling


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