In our previously published work, we support that probiotics could be used as an adjunctive treatment against COVID-19 (1) and other colleagues have also focused their attention on this subject (2, 3). Probiotics boost the immune system, enhance the mucosal barrier function and inhibit bacterial adherence and invasion capacity in the intestinal epithelium by being in a direct antagonism with pathogenic bacteria (1). The gut-lung axis is involved in the pathogenicity of bacterial and viral infections, as the intestinal microbiota boosts the alveolar macrophage activity, thus having a protective role in host defense against pneumonia (1). Along these lines, current clinical evidence connects gut, lung, and brain as an entity with communication mediated through complex neural, immunologic inflammatory, and neuroendocrine networks, the so called gut-brain-lung axis (4). There are indications in animals and humans that intestinal microbiota provides bacteria to the lungs, as abundance of Bacteroides sp. is observed in the lung following sepsis (5). Moreover, following sepsis, neurologic and cognitive outcomes are observed (4, 6). Without any doubt, the importance of the gut microbiome is stated (1). The composition of the gut microbiome may be used as a predictive tool of disease development and infection severity (1, 7, 8).
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