Abstract
Pulmonary diseases of viral origin are often followed by the manifestation of secondary infections, leading to further clinical complications and negative disease outcomes. Thus, research on secondary infections is essential. Here, we review clinical data of secondary bacterial infections developed after the onset of pulmonary viral infections. We review the most recent clinical data and current knowledge of secondary bacterial infections and their treatment in SARS-CoV-2 positive patients; case reports from SARS-CoV, MERS-CoV, SARS-CoV2 and the best-studied respiratory virus, influenza, are described. We outline treatments used or prophylactic measures employed for secondary bacterial infections. This evaluation includes recent clinical reports of pulmonary viral infections, including those by COVID-19, that reference secondary infections. Where data was provided for COVID-19 patients, a mortality rate of 15.2% due to secondary bacterial infections was observed for patients with pneumonia (41 of 268). Most clinicians treated patients with SARS-CoV-2 infections with prophylactic antibiotics (63.7%, n = 1,901), compared to 73.5% (n = 3,072) in all clinical reports of viral pneumonia included in this review. For all cases of viral pneumonia, a mortality rate of 10.9% due to secondary infections was observed (53 of 482). Most commonly, quinolones, cephalosporins and macrolides were administered, but also the glycopeptide vancomycin. Several bacterial pathogens appear to be prevalent as causative agents of secondary infections, including antibiotic-resistant strains of Staphylococcus aureus and Klebsiella pneumoniae.
Highlights
Viruses causing respiratory tract infections have been the cause of high morbidities and mortality rates worldwide, often in a seasonal manner for decades [1]
During the emergency of a viral disease, attention is initially focussed on Secondary Infections During Viral Pneumonia clinical management of the primary infection, but it is imperative to consider secondary bacterial infections that develop in patients during or following initial infection
This review focuses on secondary bacterial infections that occur in the respiratory tissue of patients suffering from a viral infection, as most lung infections by secondary bacterial pathogens remain localized in the respiratory tract, while a small percentage leads to infections that spread systematically
Summary
Viruses causing respiratory tract infections have been the cause of high morbidities and mortality rates worldwide, often in a seasonal manner for decades [1]. In one COVID-19 cohort study, described in more detail below; almost 50% (10 of 21) patients developed secondary bacterial infections in the lung caused by Klebsiella pneumoniae, Staphylococcus, Acinetobacter baumannii, and E. coli, leading to their death, despite receiving prophylactic antibiotic therapy [23]. This evaluation of all the COVID-19 reports available that reference secondary infections showed that most clinicians prescribed meropenem and linezolid to children with a rate of prophylactic treatment between 19.4 and 100.0% [24]. All eight case studies reported the treatment complications due to secondary bacterial infections
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
