Co-infection with respiratory pathogens among COVID-2019 cases

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.

Fig. 1

Distribution of respiratory pathogens with the SARS-CoV-2 co-infection.

Fig. 2

Distribution proportion of respiratory pathogens with SARS-CoV-2 co-infection. A: Distribution pathogens in different ages; B: Distribution of pathogens in different time of onset.

Fig. 3

Distribution and positive rates of co-infected respiratory pathogens. A: The nucleic acid-positive rates of 10 respiratory pathogens in 22 symptomatic category; B: The nucleic acid-positive rates of 20 pathogens in 78 mild category; C: The nucleic acid-positive rates of 22 pathogens in 140 moderate category; D: The nucleic acid-positive rates of 13 pathogens in 17 severe/critical category.