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Review
. 2022 Sep 29;10(10):1936.
doi: 10.3390/microorganisms10101936.

SARS-CoV-2: The Impact of Co-Infections with Particular Reference to Mycoplasma pneumonia-A Clinical Review

Silvia Marino  1 , Piero Pavone  2 , Lidia Marino  3 , Giuseppe Nunnari  4 , Manuela Ceccarelli  5 , Claudio Coppola  6 , Chiara Distefano  6 , Raffaele Falsaperla  1   2   3
Affiliations
Review

SARS-CoV-2: The Impact of Co-Infections with Particular Reference to Mycoplasma pneumonia-A Clinical Review

Silvia Marino et al. Microorganisms. .

Abstract

Background: After its 2019 outbreak in Wuhan, scientists worldwide have been studying the epidemiology and clinical characteristics of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in children. Evidence indicates that children with SARS-CoV-2 infection are more likely to develop upper and lower respiratory tract infections in association with other infectious agents, such as Mycoplasma pneumoniae. Here, we conducted a systematic review of SARS-CoV-2 and Mycoplasma pneumoniae co-infection and their clinical course in children. Methods: We evaluated the published literature on SARS-CoV-2 by using the medical databases PubMed, Embase, Cochrane Library, Scopus, and Web of Science. In the searches, the Medical Subject Heading (MeSH) terms "SARS-CoV-2 and Mycoplasma pneumoniae" AND "co-infection SARS-CoV-2" were used. Studies describing co-infection with SARS-CoV-2 and Mycoplasma pneumoniae in children were included in the review. The study was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: According to the PRISMA guidelines, of the 38 identified studies, 14 were conducted in children (children/adolescents 0-18 years), 6 of which were included in this review. In total, 5867 children under the age of 17 years were diagnosed with SARS-CoV-2 infection through real-time polymerase chain reaction analysis of nasopharyngeal swabs to detect viral RNA. Elevated serum IgM levels specific to Mycoplasma pneumoniae were observed in 534 children and were associated with a Kawasaki-like illness in one child. To date, all of the children are alive. Conclusion: This study underlines the importance of considering, depending on the clinical context, a possible co-infection between SARS-CoV-2 and atypical bacteria, such as Mycoplasma pneumoniae. Co-infections with other respiratory pathogens during the pandemic and hospital stay can cause mistakes in clinical diagnostic and drug treatment. Physicians should perform early differential diagnosis of SARS-CoV-2 in association with other infectious agents. Further studies are needed to have a real incidence of these co-infections and their impact on symptoms, course, and outcome of patients with SARS-CoV-2.

Keywords: COVID-19; Mycoplasma pneumoniae; SARS-CoV-2; respiratory tract co-infection.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA Flow-chart.
See this image and copyright information in PMC

References

    1. Umakanthan S., Sahu P., Ranade A.V., Bukelo M.M., Rao J.S., Lf A.-M., Dahal S., Kumar H., Kv D. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19) Postgrad. Med. J. 2020;96:753–758. doi: 10.1136/postgradmedj-2020-138234. - DOI - PMC - PubMed
    1. Pavone P., Marino S., Marino L., Cacciaguerra G., Guarneri C., Nunnari G., Taibi R., Marletta L., Falsaperla R. Chilblains-like lesions and SARS-CoV-2 in children: An overview in therapeutic approach. Dermatol. Ther. 2020;34:e14502. doi: 10.1111/dth.14502. - DOI - PubMed
    1. Pavone P., Ceccarelli M., Marino S., Caruso D., Falsaperla R., Berretta M., Rullo E.V., Nunnari G. SARS-CoV-2 related paediatric acute-onset neuropsychiatric syndrome. Lancet Child Adolesc. Health. 2021;5:e19–e21. doi: 10.1016/S2352-4642(21)00135-8. - DOI - PMC - PubMed
    1. Marino S., Taibi R., Pavone P., Marino L., Falsaperla R. Neurotropism of SARS-CoV-2 and others Coronavirus in Children: Mechanisms and Clinical Manifestations. Eurasian J. Med. Oncol. 2021;5:91–93. doi: 10.14744/ejmo.2021.78845. - DOI
    1. Williams P.C., Howard-Jones A.R., Hsu P., Palasanthiran P., Gray P.E., McMullan B.J., Britton P.N., Bartlett A.W. SARS-CoV-2 in children: Spectrum of disease, transmission and immunopathological underpinnings. Pathology. 2020;52:801–808. doi: 10.1016/j.pathol.2020.08.001. - DOI - PMC - PubMed

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