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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2026; 32(3): 112437
Published online Jan 21, 2026. doi: 10.3748/wjg.v32.i3.112437
Published online Jan 21, 2026. doi: 10.3748/wjg.v32.i3.112437
Interplay between viral infections and gut microbiota dysbiosis: Mechanisms and therapeutic potential
Tsvetelina Velikova, Dimitrina Miteva, Milena Gulinac, Latchezar Tomov, Medical Faculty, Sofia University Saint Kliment Ohridski, Sofia 1407, Bulgaria
Hassan Ali, Institute of Microbiology, Government College University Faisalabad, Faisalabad 38000, Pakistan
Hristiana Batselova, Department of Epidemiology and Disaster Medicine, Medical University, Plovdiv, University Hospital “St George”, Plovdiv 6000, Bulgaria
Lyubomir Chervenkov, Department of Diagnostic Imaging, Medical University Plovdiv, Plovdiv 4000, Bulgaria
Dimitrina Miteva, Department of Genetics, Faculty of Biology, Sofia University Saint Kliment Ohridski, Sofia 1164, Bulgaria
Milena Peruhova, Department of Gastroenterology, Heart and Brain Hospital, Burgas 8000, Bulgaria
Milena Gulinac, Department of General and Clinical Pathology, Medical University Plovdiv, Plovdiv 4002, Bulgaria
Latchezar Tomov, Department of Informatics, New Bulgarian University, Sofia 1618, Bulgaria
Yordanka Mitova-Mineva, Department of Epidemiology and Hygiene, Medical University of Sofia, Sofia 1431, Bulgaria
Valeri Velev, Department of Infectious Diseases and Parasitology, Medical University of Sofia, Sofia 1431, Bulgaria
Co-first authors: Tsvetelina Velikova and Hassan Ali.
Author contributions: Velikova T and Ali H contributed equally to this manuscript and are co-first authors. Velikova T contributed to the supervision, project administration, and funding acquisition; Velikova T, Ali H, and Velev V contributed to the conceptualization; Ali H and Mitova-Mineva Y contributed to the methodology; Batselova H and Tomov L contributed to software; Miteva D and Peruhova M contributed to the validation; Gulinac M and Tomov L contributed to formal analysis; Batselova H and Chervenkov L contributed to the investigation; Miteva D and Gulinac M contributed to resources; Mitova-Mineva Y and Velev V contributed to data curation; Velikova T and Ali H contributed to the writing - original draft preparation and visualization; Velev V contributed to the writing - review and editing. All authors have read and agreed to the published version of the manuscript. All of the authors approved the final version of the paper prior to submission.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Valeri Velev, DM, MD, PhD, Associate Professor, Department of Infectious Diseases and Parasitology, Medical University of Sofia, 2 Zdrave Street, Sofia 1431, Bulgaria. velev_md@abv.bg
Received: July 27, 2025
Revised: September 10, 2025
Accepted: December 10, 2025
Published online: January 21, 2026
Processing time: 173 Days and 14.5 Hours
Revised: September 10, 2025
Accepted: December 10, 2025
Published online: January 21, 2026
Processing time: 173 Days and 14.5 Hours
Core Tip
Core Tip: Viral infections, including those caused by emerging pathogens like severe acute respiratory syndrome coronavirus 2, can profoundly disrupt the gut microbiota, leading to dysbiosis that contributes to immune dysregulation, increased inflammation, and poorer clinical outcomes. These microbiota alterations can influence disease severity, increase susceptibility to secondary infections, and affect the metabolism of medications. Understanding the gut-virus-immune system interplay is essential for developing effective strategies to restore microbial balance. Microbiota-targeted therapies, including probiotics, prebiotics, and fecal microbiota transplantation, offer promising options for managing dysbiosis in the context of viral infectious diseases.