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Efficient bacterial fermentation is also disrupted by certain medications (eg, antibiotics) and the presence of inflammatory disease

43 : 351358 Kentroti S, Ramacci MT, Vernadakis A

Endothelial injury generated directly by intracellular viral replication and by ACE2 downregulation, exposing cells to angiotensin II in the absence of the modulator effects of angiotensin 17 (270, 271), and vascular chronic inflammation promoting the development of tissue macrophages overloaded by cholesterol (foam cells), both increase the possibility of acquiring a severe COVID-19 infection (170, 209, 258, 259, 272, 273)

This requires specialized fermentation, encapsulation, and cold-chain logistics, which greatly increase production costs compared to traditional probiotics