Human Microbiome, Virome, and Microbial Therapies Against COVID-19

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has caused huge mortality and morbidities including inflammation, oxidative stress, dysfunction of mitochondria, hypoxia, and gastro-hepatic and neurological problems. Besides the respiratory system, the digestive tract acts as a key route of entry of SARS-CoV-2 and its release into the environment. In addition to angiotensin-II-converting enzyme-2 (ACE2) in respiratory tract cells, neuropilin-1 (NRP1) and neuropilin-2 (NRP2) in respiratory and olfactory epithelium mediate binding and internalization of SARS-CoV-2 and its variants. Microbial interventions, namely, probiotics, postbiotics (such as bacteriocins, AMPs, butyrate, and niacin), fecal microbiota transplantation, and phage therapies, can modulate and restore the perturbed microbiome and prevent against SARS-CoV-2.