| dc.description.abstract | Co-infection has been reported in patients with severe acute respiratory syndrome
(SARS) and Middle East respiratory syndrome, but there is limited knowledge on co-infection
among patients with coronavirus disease 2019 (COVID-19). The prevalence of co-infection
was variable among COVID-19 patients in different studies, however, it could be up to 50%
among non-survivors. Co-pathogens included bacteria, such as Streptococcus pneumoniae,
Staphylococcus aureus, Klebsiella pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumonia, Legionella pneumophila and Acinetobacter baumannii; Candida species and Aspergillus flavus; and viruses such as influenza, coronavirus, rhinovirus/enterovirus,
parainfluenza, metapneumovirus, influenza B virus, and human immunodeficiency virus. Influenza A was one of the most common co-infective viruses, which may have caused initial falsenegative results of real-time reverse-transcriptase polymerase chain reaction for severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2). Laboratory and imaging findings alone
cannot help distinguish co-infection from SARS-CoV-2 infection. Newly developed syndromic
multiplex panels that incorporate SARS-CoV-2 may facilitate the early detection of coinfection among COVID-19 patients. By contrast, clinicians cannot rule out SARS-CoV-2 infection by ruling in other respiratory pathogens through old syndromic multiplex panels at this
stage of the COVID-19 pandemic. Therefore, clinicians must have a high index of suspicion
for coinfection among COVID-19 patients. Clinicians can neither rule out other co-infections
caused by respiratory pathogens by diagnosing SARS-CoV-2 infection nor rule out COVID-19 | |
