Introduction The novel coronavirus SARS-CoV-2 has spread all over the world causing a global pandemic and representing a great medical challenge. Nowadays, there is limited knowledge on the rate of co-infections with other respiratory pathogens, with viral co-infection being the most representative agents. Co-infection with Mycoplasma pneumoniae has been described both in adults and pediatrics whereas only two cases of Chlamydia pneumoniae have been reported in a large US study so far. Methods In the present report, we describe a series of seven patients where co-infection with C. pneumoniae (n = 5) or M. pneumoniae (n = 2) and SARS-CoV-2 was detected in a large teaching hospital in Rome. Results and conclusion An extensive review of the updated literature regarding the co-infection between SARS-CoV-2 and these atypical pathogens is also performed.

The novel coronavirus SARS-CoV-2 has spread all over the world causing a global pandemic and representing a great medical challenge. Nowadays, there is limited knowledge on the rate of co-infections with other respiratory pathogens, with viral co-infection being the most representative agents. Co-infection with Mycoplasma pneumoniae has been described both in adults and pediatrics whereas only 2 cases of Chlamydia pneumoniae have been reported in a large US study so far. In the present report, we describe a series of 7 patients where co-infection with C. pneumoniae (n=5) or M. pneumoniae (n=2) and SARS-CoV-2 was detected in a large teaching hospital in Rome. An extensive review of the updated literature regarding the co-infection between SARS-CoV-2 and these atypical pathogens is also performed.

The novel coronavirus SARS-CoV-2 has spread all over the world causing a global pandemic and representing a great medical challenge. Nowadays, there is limited knowledge on the rate of co-infections with other respiratory pathogens, with viral co-infection being the most representative agents. Co-infection with Mycoplasma pneumoniae has been described both in adults and pediatrics whereas only 2 cases of Chlamydia pneumoniae have been reported in a large US study so far. In the present report, we describe a series of 7 patients where co-infection with C. pneumoniae (n=5) or M. pneumoniae (n=2) and SARS-CoV-2 was detected in a large teaching hospital in Rome. An extensive review of the updated literature regarding the co-infection between SARS-CoV-2 and these atypical pathogens is also performed.

The novel coronavirus SARS-CoV-2 has spread all over the world causing a global pandemic and representing a great medical challenge. Nowadays, there is limited knowledge on the rate of co-infections with other respiratory pathogens, with viral co-infection being the most representative agents. Co-infection with Mycoplasma pneumoniae has been described both in adults and pediatrics whereas only 2 cases of Chlamydia pneumoniae have been reported in a large US study so far. In the present report, we describe a series of 7 patients where co-infection with C. pneumoniae (n=5) or M. pneumoniae (n=2) and SARS-CoV-2 was detected in a large teaching hospital in Rome. An extensive review of the updated literature regarding the co-infection between SARS-CoV-2 and these atypical pathogens is also performed.

BackgroundRespiratory failure is a severe complication in COVID-19 pneumonia that, in addition to oxygen therapy, may require CPAP support. It has been postulated that COVID-19 lung injury may share some features with those observed in HALI. Thus, a correct target PaO2during oxygen supplementation may be crucial to protect the lung from further tissue damage. Aims of the study were: 1) to evaluate the effects of conservative oxygen supplementation during Helmet CPAP therapy on mortality and ICU admission in patients with COVID-19 and respiratory failure; 2) to evaluate the effect of conservative oxygen supplementation on new-onset organ failure and secondary pulmonary infections.MethodsThis was a single-center, historically controlled study of patients with severe respiratory failure due to COVID-19 pneumonia, receiving either conservative or non-conservative oxygen supplementation during Helmet CPAP. A cohort receiving conservative oxygen supplementation was studied prospectively in which oxygen supplementation was administered with a target PaO2<100 mmHg. Results of this cohort were compared with those of a cohort who had received liberal oxygen supplementation.ResultsSeventy-one patients were included in the conservative cohort and 75 in the non-conservative cohort. Mortality rate was lower in the conservative cohort (22.5%versus62.7%, p<0.001). Rates of ICU admission and new-onset rate organ failure were lower in conservative cohort (14.1%versus37.3%, p=0.001, and 9.9%versus45.3% p<0.001, respectively).ConclusionsIn patients with COVID-19 and severe respiratory failure, conservative oxygen supplementation during Helmet CPAP was associated to improved survival, lower ICU admission rate and less new-onset organ failure.