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

Robert F J Kullberg¹, Brent Appelman¹, Henrike Galenkamp²

¹Center for Infection and Molecular Medicine.

The Journal of Infectious Diseases

|October 31, 2025

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.

Keywords:

COVID-19 SARS-CoV-2 anaerobic bacteria butyrate gut microbiota

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