The microbial coinfection in COVID-19

Appl Microbiol Biotechnol. 2020 Sep;104(18):7777-7785. doi: 10.1007/s00253-020-10814-6. Epub 2020 Aug 11.

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel β-coronavirus, is the main pathogenic agent of the rapidly spreading pneumonia called coronavirus disease 2019 (COVID-19). SARS-CoV-2 infects much more people, especially the elder population, around the world than other coronavirus, such as SARS-CoV and MERS-CoV, which is challenging current global public health system. Beyond the pathogenesis of SARS-CoV-2, microbial coinfection plays an important role in the occurrence and development of SARS-CoV-2 infection by raising the difficulties of diagnosis, treatment, prognosis of COVID-19, and even increasing the disease symptom and mortality. We summarize the coinfection of virus, bacteria and fungi with SARS-CoV-2, their effects on COVID-19, the reasons of coinfection, and the diagnosis to emphasize the importance of microbial coinfection in COVID-19. KEY POINTS: • Microbial coinfection is a nonnegligible factor in COVID-19. • Microbial coinfection exacerbates the processes of the occurrence, development and prognosis of COVID-19, and the difficulties of clinical diagnosis and treatment. • Different virus, bacteria, and fungi contributed to the coinfection with SARS-CoV-2.

Keywords: COVID-19; Coinfection; Microorganism; SARS-CoV-2.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antiviral Agents / therapeutic use
  • Bacterial Infections / drug therapy
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / microbiology
  • Bacterial Infections / virology
  • Betacoronavirus / drug effects
  • Betacoronavirus / immunology
  • Betacoronavirus / pathogenicity
  • COVID-19
  • Coinfection
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / microbiology
  • Coronavirus Infections / virology
  • Cytokine Release Syndrome / drug therapy
  • Cytokine Release Syndrome / epidemiology*
  • Cytokine Release Syndrome / microbiology
  • Cytokine Release Syndrome / virology
  • Cytokines / biosynthesis
  • Disease Progression
  • Host-Pathogen Interactions / immunology
  • Humans
  • Immunity, Innate / drug effects
  • Lymphocytes / microbiology
  • Lymphocytes / virology
  • Lymphopenia / drug therapy
  • Lymphopenia / epidemiology*
  • Lymphopenia / microbiology
  • Lymphopenia / virology
  • Mycoses / drug therapy
  • Mycoses / epidemiology*
  • Mycoses / microbiology
  • Mycoses / virology
  • Pandemics*
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / microbiology
  • Pneumonia, Viral / virology
  • SARS-CoV-2
  • Virus Diseases / drug therapy
  • Virus Diseases / epidemiology*
  • Virus Diseases / microbiology
  • Virus Diseases / virology

Substances

  • Anti-Bacterial Agents
  • Antiviral Agents
  • Cytokines