Clinical efficacy of probiotics in the treatment of patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials

Expert Rev Anti Infect Ther. 2023 Jun;21(6):667-674. doi: 10.1080/14787210.2023.2189100. Epub 2023 Mar 9.

Abstract

Objectives: This study was conducted to assess the clinical efficacy of probiotics in the treatment of patients with COVID19.

Methods: PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched for studies from their inception to 8 February 2022. Randomized controlled trials (RCTs) that compared the clinical efficacy of probiotics with usual care or standard care for patients with COVID19 were included. The primary outcome was all-cause mortality. Random-effects model using MantelHaenszel and inverse variance methods were performed to analyze the data.

Results: Eight RCTs with 900 patients were included. The study group receiving probiotics had a non-significantly lower rate of mortality than the control group had, but this difference was not significant (risk ratio [RR], 0.51; 95% CI, 0.22 to 1.16). However, the study group had significantly lower rates of dyspnea (RR, 0.11; 95% CI, 0.02 to 0.60), fever (RR, 0.37; 95% CI, 0.16 to 0.85) and headache (RR, 0.19; 95% CI, 0.05 to 0.65). Higher complete remission of COVID-19-associated symptoms was observed in the study group than the control group (RR, 1.89; 95% CI, 1.40-2.55).

Conclusions: Although probiotics use did not improve clinical outcomes or reduce inflammatory markers, it may relieve COVID-19-associated symptoms.

Keywords: COVID-19; meta-analysis; mortality; probiotics; randomized controlled trial; severe acute respiratory syndrome coronavirus 2.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • COVID-19*
  • Humans
  • Probiotics* / adverse effects
  • Randomized Controlled Trials as Topic
  • Treatment Outcome