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According to the leaky gut theory, these alterations in gut microbiota may be related to inadequate perfusion to the viscera due to cardiac congestion or impaired ejection capacity in patients with HF, and ischemic edema in the intestine caused by ischemia, which might increase the permeability of the intestinal epithelium (Sandek et al., 2007), thus allowing intestinal macrobiotic and bacterial metabolites to gain access to the circulatory system through the compromised barrier

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In COVID-19 patients, an increase in inflammatory cytokines, such as interleukin 6 (IL-6), IL-2, IL-7, IL-10, granulocyte colony-stimulating factor (GCSF), interferon -induced protein 10 (IP-10), monocyte chemoattractant protein 1 (MCP1), macrophage inflammatory protein 1-alpha (MIP1A), and tumor necrosis factor (TNF-), is observed which is called cytokine storm [5]

Within the circulation, chylomicrons are hydrolysed by lipoprotein lipase (LPL) to produce free fatty acids and chylomicron remnants