Bacterial and fungal co-infection is a major barrier in COVID-19 patients: A specific management and therapeutic strategy is required

Abstract

Microbial co-infections are another primary concern in patients with coronavirus disease 2019 (COVID-19), yet it is an untouched area among researchers. Preliminary data and systematic reviews only show the type of pathogens responsible for that, but its pathophysiology is still unknown. Studies show that these microbial co-infections are hospital-acquired/nosocomial infections, and patients admitted to intensive care units with invasive mechanical ventilation are highly susceptible to it. Patients with COVID-19 had elevated inflammatory cytokines and a weakened cell-mediated immune response, with lower CD4⁺ T and CD8⁺ T cell counts, indicating vulnerability to various co-infections. Despite this, there are only a few studies that recommend the management of co-infections.

Keywords: COVID-19; Co-infection; Bacterial co-infection; Fungal co-infection

Core Tip: The immune systems of coronavirus disease 2019 patients are already compromised, making them vulnerable to bacterial, fungal, and viral co-infections. These secondary infections, also known as co-infections, are hospital-acquired/nosocomial infections, and mechanically ventilated patients are especially vulnerable. There are no specific guidelines or treatment options for these types of co-infections at the moment, which is contributing to an increase in morbidity and mortality among these patients.