Anatomy

Outbreak

Internal medicine

Virology

Disease

2019-20 coronavirus outbreak

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Coronavirus disease 2019 (COVID-19)

Infectious disease (medical specialty)

Respiratory system

Medicine

Biology

Microbiology

Virus Research

• We describe the presence of 24 respiratory pathogens as co-infections in COVID-19 patients. • Most of these co-infections occurred 1–4 days after the onset of disease in COVID-19 patients. • The proportion of viral co-infections, fungal co-infections and bacterial-fungal co-infections were the highest in severe COVID-19 cases. 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.

Co-infection with respiratory pathogens among COVID-2019 cases