Fungal–Bacterial Co-Infections and Super-Infections among Hospitalized COVID-19 Patients: A Systematic Review

Abstract

This study systematically reviewed fungal–bacterial co-infections and super-infections among hospitalized COVID-19 patients. A PRISMA systematic search was conducted. On September 2022, Medline, PubMed, Google Scholar, PsychINFO, Wiley Online Library, NATURE, and CINAHL databases were searched for all relevant articles published in English. All articles that exclusively reported the presence of fungal–bacterial co-infections and super-infections among hospitalized COVID-19 patients were included. Seven databases produced 6937 articles as a result of the literature search. Twenty-four articles met the inclusion criteria and were included in the final analysis. The total number of samples across the studies was 10,834, with a total of 1243 (11.5%) patients admitted to the intensive care unit (ICU). Of these patients, 535 underwent mechanical ventilation (4.9%), 2386 (22.0%) were male, and 597 (5.5%) died. Furthermore, hospitalized COVID-19 patients have a somewhat high rate (23.5%) of fungal–bacterial co-infections and super-infections. Moreover, for SARS-CoV-2 patients who have a chest X-ray that suggests a bacterial infection, who require immediate ICU admission, or who have a seriously immunocompromised condition, empiric antibiotic therapy should be taken into consideration. Additionally, the prevalence of co-infections and super-infections among hospitalized COVID-19 patients may have an impact on diagnosis and treatment. It is crucial to check for fungal and bacterial co-infections and super-infections in COVID-19 patients.

Co-Circulation of SARS-CoV-2 and Other Respiratory Pathogens in Upper and Lower Respiratory Tracts during Influenza Season 2022–2023 in Lazio Region

“…A prompt differential diagnosis for respiratory viruses and bacteria is crucial to directing therapy and limiting the inappropriate use of antibiotics [ 19 , 20 , 21 ]. Furthermore, the detection of some relevant markers of resistance is very useful for establishing an empirically targeted therapy for the treatment of patients at risk of respiratory failure [ 2 , 7 , 22 ]. Respiratory infections can be caused by a variety of pathogens, including bacteria and viruses, usually presenting with roughly similar clinical signs and symptoms.…”

“…The authors underlined that, among the bacterial infections, more than half were multiple mixed bacterial infections, and about 30% of patients with bacterial co-infections had a severe COVID-19 diagnosis, suggesting that the simultaneous presence of bacteria could influence the morbidity and severity of COVID-19 [ 6 ]. Moreover, a recent meta-analysis has highlighted the significant role of fungal-bacterial co-infections and super-infections in COVID-19 patients [ 7 ]. Thus, it is important to note that a chest X-ray suggesting a bacterial co-infection indicates the need for immediate hospitalization, especially for immunocompromised patients.…”

“…Furthermore, the prevalence of co-infections and super-infections among hospitalized COVID-19 patients may have a considerable impact on diagnosis and treatment. Therefore, it becomes essential to verify the presence of fungal and bacterial co-infections in COVID-19 patients [ 7 ]. In this regard, the syndromic diagnostic approach can represent a true game-changer.…”