Potential Lethal Co-infections in COVID-19: A Study Based on Literature Review

Abstract

Co-infection with other respiratory pathogens has been reported in patients with COVID-19. Common respiratory pathogens can infect as co-pathogens during SARS-nCoV-2 infections. The aim of this article is to spread knowledge regarding possible co-infections during COVID-19, and reduce their occurrence. Google scholar was used to search the literature for possible co-infections in the people with COVID-19 and reviewed the existing published data. In most cases, co-infections are common due to Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumonia, Legionella pneumophila, and Acinetobacter baumannii.Prevalence of fungal and viral co-infections is low. However, Candida species and Aspergillus flavusare the common co-infective fungi. Viruses such as Influenza, Corona virus, Rhinovirus/ Enterovirus, Parainfluenza, Metapneumo virus, Influenza B virus, and Human immunodeficiency virus have also been reported as co-infecting agents during COVID-19. Influenza A was one of the most common co-infective viruses, which may have caused initial false-negative results of a real-time RT-PCR for severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). The prevalence of co-infections could be up to 50% among non-survivors. Only newly developed syndromic multiplex panels that incorporate SARS-CoV-2 may facilitate the early detection of co-infections. The suitable antimicrobial agents can be recommended for the co-infections caused by other respiratory pathogens during COVID-19.

The Assessment of Multiplex PCR in Identifying Bacterial Infections in Patients Hospitalized with SARS-CoV-2 Infection: A Systematic Review

“…The main bacteria that found were Klebsiella pneumoniae , S. aureus , Pseudomonas aeruginosa , Streptococcus pneumoniae , and Haemophilus influenzae. These results are in line with other reviews that found Streptococcus pneumoniae , S. aureus , and Klebsiella pneumoniae [ 4 , 44 ] and Pseudomonas aeruginosa and Haemophilus influenzae [ 7 ] to be the most prevalent co-infections. As S. pneumoniae was found to be one of the most frequent pathogens, one review states that pneumococcal vaccination could decrease the burden of the COVID-19 virus, as it can prevent hospitalization and, thus, the risk of contracting nosocomial bacteria [ 45 ].…”

“…In light of the fact that the virus is highly contagious, the presence of additional infections makes the clinical picture more complicated. This necessitates a multifaceted strategy and prompt treatment, as it was discovered that the majority of fatalities were due to the presence of more than one infection [ 7 , 8 , 9 , 10 ]. The most common bacterial infections, according to recent articles, systematic reviews and meta-analyses, are Klebsiella pneumoniae , Streptococcus pneumoniae , Staphylococcus aureus , Mycoplasma pneumoniae , Chlamydophila pneumoniae , Legionella pneumophila , and Acinetobacter baumannii [ 11 , 12 , 13 , 14 ].…”