Co-infections of SARS-CoV-2 with multiple common respiratory pathogens in infected patients

Lin, Dachuan; Liu, Lei; Zhang, Mingxia; Hu, Yunlong; Yang, Qianting; Guo, Jiubiao; Guo, Yun; Dai, Youchao; Xu, Yuzhong; Cai, Yi; Chen, Xinchun; Zhang, Zheng; Huang, Kaisong

doi:10.1007/s11427-020-1668-5

Cited by 123 publications

(157 citation statements)

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“…Finally, as a limited number of pediatric patients have been diagnosed in Shenzhen thus far, we have only included adult patients in this study. Effects of obesity on coronavirus infection or disease progression in children are yet to be reported (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

“…All patients with COVID-19 were carefully treated, and their data were collected by nurses, physicians, or other medical staff at the hospital. There was no missing information for all variables of interest in this study (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). We declare that no data related to obesity and COVID-19 severity from patients in our hospital have been published, submitted, or are in press.…”

Section: Study Design and Participant Criteriamentioning

confidence: 99%

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Obesity and COVID-19 Severity in a Designated Hospital in Shenzhen, China

et al. 2020

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OBJECTIVE Patients with obesity are at increased risk of exacerbations from viral respiratory infections. However, the association of obesity with the severity of coronavirus disease 2019 (COVID-19) is unclear. We examined this association using data from the only referral hospital in Shenzhen, China. RESEARCH DESIGN AND METHODS A total of 383 consecutively hospitalized patients with COVID-19 admitted from 11 January 2020 to 16 February 2020 and followed until 26 March 2020 at the Third People’s Hospital of Shenzhen were included. Underweight was defined as a BMI <18.5 kg/m2, normal weight as 18.5–23.9 kg/m2, overweight as 24.0–27.9 kg/m2, and obesity as ≥28 kg/m2. RESULTS Of the 383 patients, 53.1% were normal weight, 4.2% were underweight, 32.0% were overweight, and 10.7% were obese at admission. Obese patients tended to have symptoms of cough (P = 0.03) and fever (P = 0.06) compared with patients who were not obese. Compared with normal weight patients, those who were overweight had 1.84-fold odds of developing severe COVID-19 (odds ratio [OR] 1.84, 95% CI 0.99–3.43, P = 0.05), while those who were obese were at 3.40-fold odds of developing severe disease (OR 3.40, 95% CI 1.40–2.86, P = 0.007), after adjusting for age, sex, epidemiological characteristics, days from disease onset to hospitalization, presence of hypertension, diabetes, cardiovascular disease, chronic obstructive pulmonary disease, liver disease, and cancer, and drug used for treatment. Additionally, after similar adjustment, men who were obese versus those who were normal weight were at increased odds of developing severe COVID-19 (OR 5.66, 95% CI 1.80–17.75, P = 0.003). CONCLUSIONS In this study, obese patients had increased odds of progressing to severe COVID-19. As the severe acute respiratory syndrome coronavirus 2 may continue to spread worldwide, clinicians should pay close attention to obese patients, who should be carefully managed with prompt and aggressive treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Study Design and Participant Criteriamentioning

confidence: 99%

Obesity and COVID-19 Severity in a Designated Hospital in Shenzhen, China

et al. 2020

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“…Simultaneous coinfection with other respiratory viruses has been reported. 58 Chest computed tomography scan has been widely used to further assess patients with COVID-19. Early evidence suggests that initial chest computed tomography shows an abnormality in at least 85% of patients, with 75% of patients having a bilateral lung in-volvement that most often manifests as subpleural and peripheral areas of ground-glass opacity and consolidation.…”

Section: Middle East Respiratory Syndromementioning

confidence: 99%

Potential Effects of Coronaviruses on the Cardiovascular System

Safavi‐Naeini²,

et al. 2020

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oronaviruses (CoVs) are single-stranded positive-sense RNA viruses, with the capacity for rapid mutation and recombination. Coronaviruses are known to cause respiratory or intestinal infections in humans and animals. 1 Acute respiratory infections, including influenza, respiratory syncytial virus, and bacterial pneumonias, are well-recognized triggers for cardiovascular diseases (CVD), 2,3 and the underlying CVD is usually associated with comorbidities, which may increase the incidence and severity of infectious diseases. 4 The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, which causes coronavirus disease 2019 (COVID-19), has rapidly grown into a pandemic, and a large proportion of affected patients have been reported to have underlying CVD. 5,6 In this report, we briefly review the basics of coronaviruses and their potential effects on the cardiovascular system. Our knowledge of COVID-19 is still evolving rapidly, and this review discusses previous learnings from outbreaks of SARS and Middle East respiratory syndrome (MERS), as well as seasonal influenza, to obtain further insight into effects of coronaviruses on the cardiovascular system. Understanding the effects of COVID-19 on the cardiovascular system is essential for providing comprehensive medical care for cardiac patients. Coronaviruses in HumansCoronaviruses are named for crownlike spikes on their surface and belong to the Coronavirinae subfamily, which are further classified into 4 groups: the α, β, γ, and δ CoVs by phylogenetic clustering, of which α and β are known to cause infection in humans. 7 Coronaviruses contain 4 major structural proteins: the spike (S) protein (which mediates attachment to the host receptor and subsequent fusion of the virus and cell membrane), the nucleocapsid (N) protein, the membrane (M) protein, and the envelope (E) protein. 8 The first human CoV (HCoV) was identified in the mid-1960s in human embryonic tracheal organ cultures, and until 2003, only 2 HCoV species, HCoV-229E and HCoV-OC43, were recognized. Currently, 7 different CoV strains are known to infect humans, including HCoV-229E, HCoV-NL63, HCoV-OC43, and HCoV-HKU1, which generally cause self-resolving infection. There are also severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East Respiratory Syndrome coronavirus (MERS-CoV), and newly identified SARS-CoV-2, which can cause lethal respiratory infections in humans. 9,10 IMPORTANCE Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19) has reached a pandemic level. Coronaviruses are known to affect the cardiovascular system. We review the basics of coronaviruses, with a focus on COVID-19, along with their effects on the cardiovascular system.OBSERVATIONS Coronavirus disease 2019 can cause a viral pneumonia with additional extrapulmonary manifestations and complications. A large proportion of patients have underlying cardiovascular disease and/or cardiac risk factors. Factors associated with mortality include mal...

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“…Pulmonary co-infections with common viral,bacterial, and fungal pathogens have been described in COVID-19patients, but there is a paucity of literature on mycobacteria,including members of the Mycobacterium tuberculosiscomplex with which a third of the world population is infected [9][10][11][12]. We describe the unique case of a previously healthy childwith acute SARS-CoV-2 infection, fever, and headache, withlaboratory and imaging evidence of meningoencephalitis who rapidlydeteriorated two weeks into her illness and was found to have bothSARS-CoV-2 RNA and Mycobacterium tuberculosis complex DNAon a cerebellar biopsy with histopathology consistent withtuberculous meningitis.…”

Section: Introductionmentioning

confidence: 99%

Fatal Central Nervous System Co-Infection with SARS-CoV-2 and Tuberculosis in a Healthy Child

Freij

Gebara

Tariq

et al. 2020

Preprint

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Background. Central and peripheral nervous system symptoms and complications are being increasingly recognized among individuals with pandemic SARS-CoV-2 infections, but actual detection of the virus or its RNA in the central nervous system has rarely been sought or demonstrated. Severe or fatal illnesses are attributed to SARS-CoV-2, generally without attempting to evaluate for alternative causes or co-pathogens.Case presentation. A five-year-old girl with fever and headache was diagnosed with acute SARS-CoV-2-associated meningoencephalitis based on the detection of its RNA on a nasopharyngeal swab, cerebrospinal fluid analysis, and magnetic resonance imaging findings. Serial serologic tests for SARS-CoV-2 IgG and IgA showed seroconversion, consistent with an acute infection. Mental status and brain imaging findings gradually worsened despite antiviral therapy and intravenous dexamethasone. Decompressive suboccipital craniectomy for brain herniation with cerebellar biopsy on day 30 of illness, shortly before death, revealed SARS-CoV-2 RNA in cerebellar tissue using the Centers for Disease Control and Prevention 2019-nCoV Real-Time Reverse Transcriptase-PCR Diagnostic Panel. On histopathology, necrotizing granulomas with numerous acid-fast bacilli were visualized, and Mycobacterium tuberculosis complex DNA was detected by PCR. Ventricular cerebrospinal fluid that day was negative for mycobacterial DNA. She had no known exposures to tuberculosis and no chest radiographic findings to suggest it. All 6 family members had normal chest radiographs and negative interferon-γ release assay results. The source of her tuberculous infection was not identified, and further investigations by the local health department were not possible because of the State of Michigan-mandated lockdown for control of SARS-CoV-2 spread.Conclusion. The detection of SARS-CoV-2 RNA in cerebellar tissue and the demonstration of seroconversion in IgG and IgA assays was consistent with acute SARS-CoV-2 infection of the central nervous infection. However, the cause of death was brain herniation from her rapidly progressive central nervous system tuberculosis. SARS-CoV-2 may mask or worsen occult tuberculous infection with severe or fatal consequences.

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Co-infections of SARS-CoV-2 with multiple common respiratory pathogens in infected patients

Abstract: et al. (2020). Co-infections of SARS-CoV-2 with multiple common respiratory pathogens in infected patients. Sci China Life Sci 63, 606-609. https://doi.

Cited by 123 publications

References 5 publications

Obesity and COVID-19 Severity in a Designated Hospital in Shenzhen, China

Obesity and COVID-19 Severity in a Designated Hospital in Shenzhen, China

Potential Effects of Coronaviruses on the Cardiovascular System

Fatal Central Nervous System Co-Infection with SARS-CoV-2 and Tuberculosis in a Healthy Child

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