Abstract
IntroductionThe novel coronavirus SARS-CoV-2 has spread all over the world causing a global pandemic and representing a great medical challenge. Nowadays, there is limited knowledge on the rate of co-infections with other respiratory pathogens, with viral co-infection being the most representative agents. Co-infection with Mycoplasma pneumoniae has been described both in adults and pediatrics whereas only two cases of Chlamydia pneumoniae have been reported in a large US study so far.MethodsIn the present report, we describe a series of seven patients where co-infection with C. pneumoniae (n = 5) or M. pneumoniae (n = 2) and SARS-CoV-2 was detected in a large teaching hospital in Rome.Results and conclusionAn extensive review of the updated literature regarding the co-infection between SARS-CoV-2 and these atypical pathogens is also performed.
Highlights
The novel coronavirus SARS-CoV-2 has spread all over the world causing a global pandemic and representing a great medical challenge
In the present report we described for the first time in Europe [2, 17] that patients with SARS-CoV-2 infection might be co-infected, among agents of atypical pneumonia, with M. pneumoniae and with C. pneumoniae
As the majority of symptomatic patients with SARS-CoV-2 infection develop an atypical pneumonia syndrome with fever, cough, and shortness of breath, co-infections with C. pneumoniae or M. pneumoniae are likely obscured, making difficult the differential diagnosis only based on clinical presentation [19, 20]
Summary
The novel coronavirus ( called SARS-CoV-2) initially discovered in Wuhan, China, has spread all over the world causing a global pandemic and representing a great medical challenge in terms of treatment, prevention and, not less important, diagnosis [1]. While early reports from China and Spain described co-infection as a rare event (6/104, 5.7% and 3/103, 2.9%, respectively) [4, 5], Kim et al reported the presence of one or more additional pathogen in 24 of 116 patients (20.6%) diagnosed with SARS-CoV-2 infection [6] whereas another study from China showed that up to 80% of SARS-CoV-2 infected subjects had IgM positivity against at least one respiratory agent, highlighting how the detection of other respiratory pathogens cannot be used to rule out COVID-19 diagnosis [7] It is still unknown whether co-infection with other pathogens, and in particular with intracellular atypical microorganisms, might play a role in determining the prognosis of SARS-CoV-2 infection. When clinical outcomes (ICU admission and intra-hospital mortality) of 175 patients without M
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