Medicine and Health

High Prevalence of Respiratory Co-Infections and Risk Factors in COVID-19 Patients at Hospital Admission During an Epidemic Peak in China

X. Zhu, F. Tian, et al.

This intriguing study evaluated 716 COVID-19 patients in a Chinese hospital, revealing a staggering 76.82% co-infection rate with 11 pathogens, predominantly bacterial. The most common culprits were *Streptococcus pneumoniae* and *Haemophilus influenzae*. With insights on mortality risk factors such as dyspnea and *Mycoplasma pneumoniae* co-infection, researchers stress the importance of better antibiotic management. This vital work was conducted by Xiaoying Zhu, Fengqin Tian, Yulei Li, Qunfeng Lu, Qinqin Long, Xidai Long, and Demin Cao.

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Abstract

Background: Recent research highlights the contribution of co-infections to elevated disease severity and mortality among COVID-19 patients. Given China's decision to ease epidemic prevention policies in December 2022, a comprehensive exploration of the risks and characteristics of co-infections with respiratory pathogens becomes imperative. Methods: We conducted a retrospective analysis of 716 COVID-19 patients admitted to a primary hospital in China. The detection of twelve respiratory pathogens was conducted using qPCR, and the potential risk factors were analyzed through Cox regression analysis. Results: Within this cohort, 76.82% of cases exhibited co-infection involving eleven distinct pathogens. Among these, bacterial co-infections were observed in 74% of cases, with Streptococcus pneumoniae and Haemophilus influenzae emerging as the most prevalent bacterial co-infection agents. Additionally, 15% of cases presented with viral co-infections, predominantly involving influenza A virus and respiratory syncytial virus. Nevertheless, our investigation suggested that there might be some inappropriate antibiotic use in treatments. Furthermore, risk analysis unveiled dyspnea, hypoproteinemia, low lymphocyte counts, and co-infection with Mycoplasma pneumoniae as prominent risk factors for COVID-19 inpatients. Conclusion: Our findings underscore a significant occurrence of co-infections among COVID-19 patients during the epidemic, emphasizing the need for enhanced antibiotic stewardship. Effective management strategies should encompass respiratory status, nutritional aspects, and vigilance towards co-infections involving M. pneumoniae during COVID-19 treatment. This study underscores the significance of comprehensive management protocols to address the multifaceted challenges presented by co-infections in COVID-19 patients.

Publisher

Infection and Drug Resistance

Published On

Oct 25, 2023

Authors

Xiaoying Zhu, Fengqin Tian, Yulei Li, Qunfeng Lu, Qinqin Long, Xidai Long, Demin Cao

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