Suggested future research
Based on the above considerations, it is suggested that studies should
be conducted to assess the dietary patterns and other lifestyle factors
of people who have asymptomatic, mild or severe COVID-19 infections to
determine what factors are most associated with various outcomes. During
the pandemic crisis, it may be difficult to do these types of studies,
but it might be possible via telephone or online surveys of families of
those who are ill and/or hospitalized, to assess eating patterns and
lifestyle factors of those who got sick and those who did not. For those
who are deceased, information on dietary patterns and lifestyle factors
could be obtained from close relatives.
Eventually, when there is improved availability of testing and more
types of tests for COVID-19, including tests for past exposure using
antibody measurements, it should become easier to do these types of
studies. Of course, prospective studies are preferable, however, they
may not be possible in many cases in the midst of the current pandemic.
Preferably, samples of the microbiome from a variety of sites, perhaps
including oral, fecal, blood, urinary and respiratory tract, would be
gathered before the illness develops to help assess microbiome-related
risk factors. If this is not possible, information on the microbiome
might be inferred from diet and lifestyle data, drawing on the growing
amount of research on the relationship between these factors and the
microbiome composition. The use of large databases of previously
gathered microbiome data might also be considered for inclusion in these
types of studies. In some cases, autopsy samples of many different
organs could be analyzed to attempt to detect microbiome-related
patterns.
In addition, the expansion of the types of immune system manipulation
methods being studied in cases of severe COVID-19 might be considered.
As mentioned above, research could be conducted on medications that are
related to mast cell function and/or inhibit hypersensitivity reactions.
The use of microbiota manipulation or antimicrobials that target
components of a potentially dysbiotic microbiota could be considered.
These might be studied alone or in combination with other treatment
approaches.