Gut Microbiota Predicts the Risk of Future COVID-19 Hospitalization and Mortality: Insights From the Population-Based HELIUS Study.

Kullberg, Robert F J; Appelman, Brent; Galenkamp, Henrike; Prins, Maria; van den Born, Bert-Jan; Nieuwdorp, Max; Haak, Bastiaan W; Wiersinga, W Joost · J Infect Dis · 2026

prospective_cohort · Level II

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Abstract

Gut microbiota are disrupted in patients hospitalized for COVID-19, with a loss of anaerobic bacteria-producing butyrate. Yet, these disruptions could either be a consequence of the infection itself or increase susceptibility from the outset. Here, we investigated whether gut microbiota influence the risk of future COVID-19 hospitalization and mortality. In 5084 participants of a population-based cohort, gut microbiota composition was associated with the risk of future severe COVID-19. Specifically, increased abundances of butyrate-producing bacteria were associated with a lower risk of severe COVID-19. Together, gut microbiota alterations precede severe COVID-19 and may represent a novel target for prevention.

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