Co-infection at the Time of Hospital Admission in Patients with COVID-19 Infection

Abstract

Background: Co-infections with Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) lead to unfavourable outcomes. However, data on prevalence of various co-infections in SARS-CoV-2 positive patients on admission to the hospital is sparse. This study focusses on assessing co-infection rates and common pathogenic bacteria and fungus involved in these patients. Methods: Patients admitted between April 2020 and December 2020 with Corona Virus Disease-2019 (COVID-19) were included. Criteria for co-infection using definitions were developed. All microbiological investigations of these patients performed within first 48 hours of admission were analysed. Their demographic characteristics along with existing co-morbidities, presenting symptoms, other laboratory findings on admission and clinical outcome were also reviewed. Results: Of 1566 patients, 60% were males.64% belonged to 13-65 years age-group. 4% of COVID-19 positive patients were co-infected. 451 samples were received for culture of which urine were 66%, blood 23% and sputum 11%. 15% samples showed growth of which urine were 19%, blood 10% and sputum 2%. Bacteria isolated were 91% and fungus 9%. The common bacteria isolated were E. coli 46%, Klebsiella pneumoniae 25%, Stenotrophomonas maltophila 6% and Pseudomonas aeruginosa 4%. The common fungus isolated was Candida species 7%.10% of COVID-19 positive patients with co-infection expired and 90% recovered. Conclusion: We report a 4% rate of bacterial and fungal co-infection in COVID-19 positive patients on admission mostly related to Enterobacterales, Non-fermenting Gram-negative bacilli and Candida species. This data can be valuable in optimising the use of antibiotics and antifungals in our patients. Similar studies on co-infection and its various aspects are the need of the hour.