The COVID-19 Pandemic: a Threat to Antimicrobial Resistance Containment

Abstract

As of 23 April 2021, the outbreak of COVID-19 claimed around 150 million confirmed cases with over 3 million deaths worldwide. Yet, an even more serious but silent pandemic, that of antimicrobial resistance (AMR), is likely complicating the outcome of COVID-19 patients. This study discusses the current knowledge on the emergence of the SARS-CoV-2 and highlights the likely contribution of the COVID-19 pandemic on the escalation of AMR. COVID-19 engenders extensive antibiotic overuse and misuse, and will undoubtedly and substantially increase AMR rates worldwide. Amid the expanding COVID-19 pandemic, policymakers should consider the hidden threat of AMR much more, which may well be enhanced through improper use of antibiotics to treat patients with severe COVID-19 infection.

Prevalence of Bacterial Coinfection and Patterns of Antibiotics Prescribing in Patients with COVID-19: A Systematic review and Meta-Analysis

“…This can potentially be attributed to a number of factors including social distancing measures and reduction in medical activities [67][68][69] . Nonetheless, inappropriate use of antibiotics during COVID-19 is a potential driver of the silent AMR pandemic [24,70] . However, with current changes observed in global human behaviour, relating to personal hygiene, and increased interest in infection control since the emergence of this pandemic, we should see a rise in AMS activities globally [71] .…”

“…Consequently, this review aims at building on these publications through identifying the prevalence of bacterial co-infection, and the prevalence of antibiotic use in patients with COVID-19 across multiple countries and regions to guide future prescribing. This includes reducing the inappropriate use of antimicrobials during the COVID-19 pandemic where inappropriate use is a potential driver of antimicrobial resistance (AMR) [24, 25, 34]…”

“…Consequently, this review aims at building on these publications through identifying the prevalence of bacterial coinfection, and the prevalence of antibiotic use in patients with COVID-19 across multiple countries and regions to guide future prescribing. This includes reducing the inappropriate use of antimicrobials during the COVID-19 pandemic where inappropriate use is a potential driver of antimicrobial resistance (AMR) [24,25,34] bacterial infection; clinical outcomes of co-infected patients; antibiotic class prescribed; timing of antibiotic initiation in relation to COVID-19 onset and clinical outcomes of patients prescribed antibiotics. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the observational studies included in the review [35] .…”

Phage therapy in the Covid-19 era: Advantages over antibiotics

“…On the contrary, 74.6 % of patients are given antibiotics as a preventative measure to avoid secondary infection ( Langford et al, 2021 ). This scenario suggests that antibiotics are being used inappropriately and possibly excessively in COVID treatment, which may result in a significant increase in antibiotic-resistant organisms in a short period of time ( Founou et al, 2021 ; Livermore, 2021 ). Antibiotic resistance is already predicted to become a pandemic by 2050, causing 10 million deaths per year worldwide.…”

Epigenetic Mechanisms Underlying COVID-19 Pathogenesis

“…In particular, the results of a large placebo-controlled trial of vaccines from Pfizer and Moderna have shown that two repeated doses of the vaccine are highly effective in preventing COVID-19 (more than 90%) [10,11]. Based on the results of these clinical trials, vaccination with multiple types of COVID-19 vaccines developed by several pharmaceutical companies began worldwide at the end of 2020 or in early 2021 [12]. While hopes for pandemic containment through vaccination are increasing, the emergence of SARS-CoV-2 variants with amino acid mutations in the antigenic determinants of spike proteins, as described above, has been reported worldwide.…”