Co-infection with respiratory pathogens among COVID-2019 cases

Xiaojuan Zhu; Yiyue Ge; Tao Wu; Kangchen Zhao; Yin Chen; Bin Wu; Fengcai Zhu; Baoli Zhu; Lunbiao Cui

doi:10.1016/j.virusres.2020.198005

Co-infection with respiratory pathogens among COVID-2019 cases

Virus Res. 2020 Aug:285:198005. doi: 10.1016/j.virusres.2020.198005. Epub 2020 May 11.

Authors

Xiaojuan Zhu¹, Yiyue Ge¹, Tao Wu¹, Kangchen Zhao¹, Yin Chen¹, Bin Wu¹, Fengcai Zhu¹, Baoli Zhu², Lunbiao Cui³

Affiliations

¹ NHC Key laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
² NHC Key laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China; From Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China. Electronic address: zhubl@jscdc.cn.
³ NHC Key laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China. Electronic address: lbcui@jscdc.cn.

Abstract

Accumulating evidence shows that microbial co-infection increases the risk of disease severity in humans. There have been few studies about SARS-CoV-2 co-infection with other pathogens. In this retrospective study, 257 laboratory-confirmed COVID-19 patients in Jiangsu Province were enrolled from January 22 to February 2, 2020. They were re-confirmed by real-time RT-PCR and tested for 39 respiratory pathogens. In total, 24 respiratory pathogens were found among the patients, and 242 (94.2 %) patients were co-infected with one or more pathogens. Bacterial co-infections were dominant in all COVID-19 patients, Streptococcus pneumoniae was the most common, followed by Klebsiella pneumoniae and Haemophilus influenzae. The highest and lowest rates of co-infections were found in patients aged 15-44 and below 15, respectively. Most co-infections occurred within 1-4 days of onset of COVID-19 disease. In addition, the proportion of viral co-infections, fungal co-infections and bacterial-fungal co-infections were the highest severe COVID-19 cases. These results will provide a helpful reference for diagnosis and clinical treatment of COVID-19 patients.

Keywords: COVID-19; Co-infection; RT-PCR; SARS-CoV-2.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Age Factors
Aged
Bacterial Infections / complications*
Betacoronavirus*
COVID-19
Coinfection*
Coronavirus Infections / complications*
Female
Humans
Male
Middle Aged
Mycoses / complications*
Pandemics
Pneumonia, Viral / complications*
Retrospective Studies
SARS-CoV-2
Time Factors
Virus Diseases / complications*
Young Adult