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Comment
. 2020 Jul 7;12(7):e12560.
doi: 10.15252/emmm.202012560. Epub 2020 Jun 15.

SARS-CoV-2, bacterial co-infections, and AMR: the deadly trio in COVID-19?

Jose A Bengoechea  1 , Connor Gg Bamford  1
Affiliations
Comment

SARS-CoV-2, bacterial co-infections, and AMR: the deadly trio in COVID-19?

Jose A Bengoechea et al. EMBO Mol Med. .

Abstract

Respiratory viral infections are well known to predispose patients to bacterial co-infections and superinfections. Still, there is limited reference to these in COVID-19. Do co-infections play a significant role during COVID-19? What is the impact of antimicrobial resistance?

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Figures

Figure 1
Figure 1. The interplay between SARS‐CoV‐2, bacteria and the host in co‐infections
(A) SARS‐CoV‐2 virulence factors interact with the lungs and evoke an immune response. These interactions may compromise innate immunity at several levels resulting in increased bacterial attachment, growth and dissemination. Viral infection may uncover bacterial receptors mediating bacterial attachment. Co‐infection may result in an exuberant inflammatory response. It is also plausible that the type of immune response induced by SARS‐CoV‐2 may enable bacteria to flourish in the lungs. On the other hand, bacterial colonisation may predispose to SARS‐CoV‐2 infection because the innate immune host defences may be down‐regulated enabling virus survival, growth and pathology. (B) Co‐infection may exacerbate the tissue damage; and the exuberant inflammatory response may further amplify the lung damage triggered by SARS‐CoV‐2.
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