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Virus Research
Vol. 285, 2020, 198005

Co-infection with respiratory pathogens among COVID-2019 cases

Xiaojuan Zhua,1, Yiyue Gea,1, Tao Wua, Kangchen Zhaoa, Yin Chena, Bin Wua, Fengcai Zhua, Baoli Zhua,b, Lunbiao Cuia

NHC Key laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.


Accumulating evidence shows that microbial co-infection increases the risk of disease severity in humans. There have been few studies about SARS-CoV-2 co-infection with other pathogens. In this retrospective study, 257 laboratory-confirmed COVID-19 patients in Jiangsu Province were enrolled from January 22 to February 2, 2020. They were re-confirmed by real-time RT-PCR and tested for 39 respiratory pathogens. In total, 24 respiratory pathogens were found among the patients, and 242 (94.2 %) patients were co-infected with one or more pathogens. Bacterial co-infections were dominant in all COVID-19 patients, Streptococcus pneumoniae was the most common, followed by Klebsiella pneumoniae and Haemophilus influenzae. The highest and lowest rates of co-infections were found in patients aged 1544 and below 15, respectively. Most co-infections occurred within 14 days of onset of COVID-19 disease. In addition, the proportion of viral co-infections, fungal co-infections and bacterial-fungal co-infections were the highest severe COVID-19 cases. These results will provide a helpful reference for diagnosis and clinical treatment of COVID-19 patients.

Keywords : SARS-CoV-2, COVID-19, RT-PCR, Co-infection.

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