Open AccessCo-infection in patients with hypoxemic pneumonia due to COVID-19 in Reunion Island
Author(s) -
Nicolas Allou,
Kevin P. Larsen,
Arthur Dubernet,
Nicolas Traversier,
L Massé,
Emilie Foch,
Léa Bruneau,
Adrien Maillot,
André Meynier,
Marie Lagrange-Xélot,
Jérôme Allyn,
Vincent C. Thomas,
Nathalie Coolen-Allou
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000024524
Subject(s) - medicine , pneumonia , streptococcus pneumoniae , incidence (geometry) , staphylococcus aureus , haemophilus influenzae , rhinovirus , coronavirus , virology , virus , microbiology and biotechnology , covid-19 , disease , antibiotics , infectious disease (medical specialty) , physics , genetics , optics , bacteria , biology
This study aimed to evaluate the incidence of co-infection with different types of pathogens in patients with hypoxemic pneumonia due to coronavirus disease 2019 (COVID-19) in Reunion Island. This observational study using a prospectively collected database of hypoxemic pneumonia due to COVID-19 cases was conducted at Félix Guyon University Hospital in Reunion Island, France. Between 18 March 2020 and 15 April 2020, 156 patients were admitted to our hospital for COVID-19. A total of 36 patients had hypoxemic pneumonia (23.1%) due to COVID-19. Thirty of these cases (83.3%) were imported by travelers returning mainly from metropolitan France and Spain. Patients were screened for co-infection with other pathogens at admission: 31 (86.1%) by multiplex polymerase chain reaction (PCR) and 16 (44.4%) by cytobacteriological examination of sputum culture. Five patients (13.9%) were found to have co-infection: 1 with influenza virus A H1N1 (pdm09) associated with Branhamella catarrhalis , 1 with Streptococcus pneumoniae associated with Haemophilus influenzae , 1 with Human Coronavirus 229E, 1 with Rhinovirus, and 1 with methicillin-susceptible Staphylococcus aureus . Patients with co-infection had higher D-dimer levels than those without co-infection (1.36 [1.34–2.36] μg/mL vs 0.63 [0.51–1.12] μg/mL, P = .05). The incidence of co-infection in our cohort was higher than expected (13.9%). Three co-infections (with influenza virus A(H1N1) pdm09, Streptococcus pneumoniae , and Staphylococcus aureus ) required specific treatment. Patients with hypoxemic pneumonia due to COVID-19 should be screened for co-infection using respiratory cultures or multiplex PCR. Whilst our study has a number of limitations, the results from our study suggest that in the absence of screening, patients should be commenced on treatment for co-infection in the presence of an elevated D-dimer.