Children whose symptoms linger four weeks after COVID-19 infections have different types of gut bacteria, as well as signs their gut barrier could be compromised.

Researchers found a significant decrease in beneficial, health-protective bacteria in children who had a COVID-19 infection compared with healthy children in one of the top studies presented today at the Gut Microbiota for Health World Summit in Washington, D.C. The summit was organized by the American Gastroenterological Association and the European Society of Neurogastroenterology and Motility.

The gut microbiome—consisting of bacteria, viruses, fungi, and other microorganisms—has a symbiotic or mutually beneficial relationship with the immune system to maintain homeostasis or good health. Any alteration in this two-way system can create illness and undesirable symptoms.

This new study in children mirrors early research showing the gut microbiome’s involvement in adult cases of post-acute COVID-19 syndrome (PACS), a persistence of symptoms beyond the initial infection. It’s also sometimes referred to as long COVID.

Researchers hypothesized that dysbiosis—or an imbalance of gut bacteria—could also be driving ongoing symptoms in children.

Study Specifics

Stool samples from 186 children—including those who were healthy, those who recovered from infection, and those struggling with gastrointestinal or neuropsychiatric symptoms four weeks past infection—revealed trends in microbiome data.

Among those trends were:

• Uniquely different microbiomes of those with PACS, with 41 different species being more abundant—including Streptococcus—compared with children with fewer or no gastrointestinal symptoms.


• Persistent gastrointestinal symptoms corresponded with elevated fecal calprotectin, a protein made by a type of white blood cell that rushes to the gut when there is inflammation or infection.


• Less overall microbiome diversity in children with neuropsychiatric symptoms and less microbiome diversity compared with those with children with no neuropsychiatric symptoms. Diversity of bacteria species is equated with better health.


• Decreased Bifidobacterium breve—a bacteria beneficial to humans—among children with neuropsychiatric symptoms.


• Increased fecal zonulin, a marker of intestinal permeability, among those with neuropsychiatric symptoms.

Intestinal permeability refers to loose junctions of the intestinal epithelium that can allow microorganisms to migrate into the body where they don’t belong and cause sustained inflammation. The condition may also be referred to as leaky gut syndrome. It should be noted, however, that leaky gut syndrome is still being researched as a standalone condition, and its role in various health issues remains a topic of ongoing scientific debate.

Some of the neuropsychiatric symptoms reported by children in the study included jerking of limbs, behavior changes, persistent headaches, and balance problems.

“Taken together, it may be possible to better identify PACS in the pediatric population through microbiome profiling and utilize microbial therapeutics to ameliorate persistent symptoms,” the authors said.

Could Probiotics Help?

Probiotics, a microbial therapeutic, hold promise to alleviate symptoms related to long COVID, according to the authors of a review published in Gut Microbes. Of note, the review addressed long COVID in adults, not children per se.

“However, caution must be taken since these interventions improve parts of the disease, but do not cure” long COVID, the authors wrote.

They pointed to research showing only some of the symptoms are alleviated with probiotic-targeted treatments with no overall significant change in quality of life. More studies are needed before personalized treatment can be developed to restore the gut microbiome in cases related to long COVID, they said.

Easy Dietary Changes

In the meantime, diet could be one way to safely influence the gut microbiome for better gut health, according to Dr. Cammy Benton, a family physician and integrative practitioner.

For children who are struggling with  COVID-19 or any other infection, she told The Epoch Times her top recommendation is to avoid processed food.

“If it comes in a box or a bag and God didn’t make it, you shouldn’t eat or drink it. If you can’t pluck it off a tree, out of the earth, kill it, or milk it, you shouldn’t eat or drink it,” she said. “If it’s made in a factory, you shouldn’t eat or drink it. If it’s got a list of ingredients you don’t recognize, don’t eat or drink it.”

Benton suggested that COVID patients eat fermented foods, which contain naturally occurring probiotics, being mindful not to eat or drink fermented dairy with artificial dyes or sugar added. Bone broth or collagen can also be used to support gut health, she said.

Additionally, Benton said to “eat the rainbow” because eating diverse fruits and vegetables has been shown to improve microbiome diversity. Plants also boost essential vitamins.

“They’ve shown you can change your gut flora within three to four days of changing from a standard American diet to an organic diet,” she added. “Little things can make big changes. It comes down to paying attention to what we put into our stomach.”

Fiber, which is found in fruits and vegetables, holds the most promise for reversing leaky gut, according to an article in Gastroenterology and Hepatology.

“In addition to helping to maintain a healthy intestinal surface mucous membrane, dietary fiber also contains microbiota-accessible carbohydrates (MACs), which have been shown to enhance expression of tight junction proteins; furthermore, evidence suggests that short-chain fatty acids, a fermentation product of MACs, may improve intestinal barrier function,” the authors wrote.

Stress and Gut Health

If there’s one more piece of advice Benton has, it’s this: Minimize stress and aim to live a joyful life.

Stress can contribute to a leaky gut. She pointed to research showing the effects of trauma are generally worse if your gut microbiome is unbalanced.

“There are so many reasons to support a healthy gut, not just for long COVID but for protecting your mental health, your physical health, and to go through any future traumatic events with grace and ease.”