Open AccessClinical and etiological analysis of co‐infections and secondary infections in COVID‐19 patients: An observational study
Author(s) -
Chen Shuyan,
Zhu Qing,
Xiao Yanyu,
Wu Chi,
Jiang Zhaofang,
Liu Lei,
Qu Jiuxin
Publication year - 2021
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.13369
Subject(s) - medicine , mycoplasma pneumoniae , procalcitonin , streptococcus pneumoniae , respiratory tract infections , haemophilus influenzae , etiology , immunology , pneumonia , antibiotics , sepsis , respiratory system , microbiology and biotechnology , biology
Background Co‐infections, secondary bacterial or fungal infections, are important risk factors for poor outcomes in viral infections. The prevalence of co‐infection and secondary infection in patients infected with SARS‐CoV‐2 is not well understood. Aims To investigate the role of co‐infections and secondary infections in disease severity of hospitalized individuals with COVID‐19. Materials and Methods A retrospective study was carried out between 11 January 2020 and 1 March 2020 among 408 laboratory confirmed COVID‐19 patients in China. These patients were divided into three groups based on disease severity: mild or moderate, severe, or critically ill. Microbiological pathogens in blood, urine, and respiratory tract specimens were detected by the combination of culture, serology, polymerase chain reaction, and metagenomic next‐generation sequencing (mNGS). Results The median age of participants was 48 years (IQR 34–60 years). Fifty‐two patients (12.7%) had at least one additional pathogen, 8.1% were co‐infected, and 5.1% had a secondary infection. There were 13 Mycoplasma pneumoniae cases, 8 Haemophilus influenzae cases, 8 respiratory viruses, and 3 Streptococcus pneumoniae cases, primarily detected in mild and moderate COVID‐19 patients. Hospital‐acquired infection pathogens were more common in critically ill patients. Compared to those without additional pathogens, patients with co‐infections and/or secondary infections were more likely to receive antibiotics ( p < 0.001) and have elevated levels of d‐dimer ( p = 0.0012), interleukin‐6 ( p = 0.0027), and procalcitonin ( p = 0.0002). The performance of conventional culture was comparable with that of mNGS in diagnosis of secondary infections. Conclusion Co‐infections and secondary infections existed in hospitalized COVID‐19 patients and were relevant to the disease severity. Screening of common respiratory pathogens and hospital infection control should be strengthened.