Co-infections in patients with COVID-19

ABSTRACT

Background and Aim of the study Several studies show that microbial co-infection increases the risk of disease severity in humans, but there is limited knowledge on co-infection amongpatients with coronavirus disease 2019 (COVID-19). The aim ofthe study was to evaluate co-infections with other pathogensamong COVID-19 cases. Methods: In this study, we analyzed the laboratory-confirmedCOVID-19 consecutive patients admitted at Miulli General Hospitalfrom the 17th of March to the 31th of May 2020. We included patients in all settings, either in Covid wards and in ICU. We soughtto define the prevalence of patients with bacterial and fungal coinfections.Results: Overall, 233 patients (M 59%;age 67±18 years) were examined;52 (22.3%) of them were co-infected with one or morepathogens;in total 27 respiratory pathogens were found. Copathogens included different bacteria such as Staphylococcus aureus, Klebsiella pneumoniae, Mycoplasma, Chlamydia and Candidaspecies. In addition, 7.7% of patients had pathogens with resistancegenes. Most co-infections occurred within 5 days of onset of COVID-19 disease. A higher prevalence of ICU patients had bacterial coinfections than patients in a mixed ward (72.7% vs 17.1%;p<0.001), and the fungal co-infections and bacterial-fungal co-infections were more prevalent in severe COVID-19 cases.Conclusions: A low proportion of COVID-19 patients have a bacterial co-infection;while in ICU the prevalence increases. These results suggest that routine antibiotics might not be indicated inpatients with COVID-19.