Leaky gut and COVID-19: Is there a connection?

Do leaky gut and COVID-19 share some sort of a relationship? According to a recent study they do. And when you look at other data as well as the mechanism, it definitely makes sense!

In this paper, researchers found that a certain set of inflammatory biomarkers in the blood could predict severe COVID-19 outcomes. Researchers believe this inflammatory milieu in the blood drives the cytokine storm that increases fatality rate.

Consequently, they identified members of the microbiome and enriched functional pathways in these patients. The risk assessment tool works primarily for those over the age of 58.

But it’s important to point out what this means. When most people think of age, they think of chronological age. In other words, how many years have passed since birth.

Biological age, on the other hand, is a completely different concept and physiologically more important. Essentially, biological age is measure of how well the body functions. It normally correlates pretty well with chronological age, but not always.

It’s easy to conceptualize this using cars as an analogy. Chronological age is akin to the production year of a car, while biological age is akin to the mileage. Both matter, but ultimately a car with lower miles will perform better than a car with higher miles, regardless of age.

You already know your biological age. Find your chronological age ...
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Aging, leaky gut and COVID-19

With aging comes alterations in the microbiome. As a result, our gut gets leakier, systemic inflammation increases, and our immune system malfunctions. But this isn’t merely a product of chronological aging.

This change in gut leakiness and the microbiome is driven by mileage, not the year of the “car”. I covered this in a blog and podcast early last year. Despite being older chronologically, disease-free centenarians had a stronger gut than people 60 years their junior. Older chronologically, but biologically a similar age.

Furthermore, another study found that people who were healthy at 100 had a similar microbiome to people who were several decades younger and health. So, again, it’s the mileage, not the year.

But what factors drive the mileage up? A recent paper indicates obesity accelerates the aging process. A blog at Fight Aging! summarized a review last year showing essentially the same thing as well.

Finally, a paper published this year identified some markers of frailty in older age. They found metabolites in the blood of the elderly frail with type 2 diabetes are elevated compared to healthy elderly controls. Of the 7 markers elevated, 5 are identical to those found in people with severe COVID-19 outcomes.

Frailty in old age is essentially a marker of accelerated aging. In other words, there seems to be an intensely strong relationship between biological age and severe COVID-19 outcomes. And since there’s a relationship between leaky gut and biological age, there’s also a likely relationship between leaky gut and COVID-19 outcomes.

This explains why factors associated with accelerated biological aging(Obesity, hypertension, T2D, and CVD) lead to poor outcomes, regardless of age. And to be completely honest, I chalk this up to putting more mileage on the car with bad habits than just a combination of dumb luck and time.


Gut health is very important to overall health. Increased intestinal permeability, aka leaky gut, is associated with chronological age. But more importantly, it seems that it is more closely associated with biological age. This is an important distinction because we have some level of control over biological age, but not chronological age.

Important factors for healthy aging include:

  • Exercise
  • Strong & synchronized circadian rhythms
  • Reducing sedentary time
  • Maintaining a healthy weight
  • Getting adequate high quality sleep
  • Managing stress
  • Not smoking
  • Eating a healthy diet
  • Calorie restriction

I’ve covered the importance of some of these factors and how they affect leaky gut in a free course you can check out called 3 Common Causes of Leaky Gut.

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