Bacterial, viral, and fungal infections among patients with coronavirus disease 2019: A mini-review

Abstract

Infections with bacteria, viruses, and fungi have been reported in coronavirus disease patients, however, data on these infections are still scarce. These infections are categorized as either community or hospital-acquired infections and may be described as coinfections or secondary/superinfection. The proportion of these infections varied widely across studies. Hospital-acquired infections, especially bacterial or fungal infections, are frequently complicating the course of intensive care unit (ICU) patients and associated with increased morbidity and mortality. The most common hospital-acquired superinfections are ventilator-associated pneumonia, hospital-acquired pneumonia, and bacteremia. The coprevalence of community-acquired secondary bacterial pneumonia and COVID-19 infection is unusual. Co-infection with COVID-19 and tuberculosis (TB) has also been reported. COVID-19 and TB patients frequently experience coughing, fever, and shortness of breath. This can lead to diagnostic confusion as well as worsening stigmatization of TB patients, especially in low-and middle-income countries (LMICs). Empiric antibiotics may not be required in the majority of COVID-19 patients, particularly those not severely ill. Superinfections by antibiotic-resistant bacteria have also been reported among critically ill patients with COVID-19 infection. The most prevalent identified viruses among COVID-19 patients are influenza type A, influenza type B, and respiratory syncytial virus. Patients with severe COVID-19 infection are also at risk for fungal infections such as Aspergillus, Candida, Pneumocystis, or other fungal species, which has been linked to increased morbidity and mortality such as Mucormycosis.