Abstract

PARAEPIDEMICS: THE ROLE OF MICROBIAL CO-INFECTIONS AND SUPERINFECTIONS ON THE COVID-19

Antonio Neres Norberg*, Paulo Roberto Blanco Moreira Norberg, Fabiano Guerra Sanches, Paulo Cesar Ribeiro, Nadir Francisca Sant'Anna, Renato Mataveli Ferreira Filho and Ligia Cordeiro Matos Faial

ABSTRACT

Despite the scarcity of information due to the recent emergence of the disease, the results already achieved indicate that an important parcel of the aggravations and mortality in cases of COVID-19 syndrome may be attributed to secondary infections, along the natural immunity loss and viral replication in the lower respiratory tract, which leads to an extensive lung injury and severe acute respiratory syndrome. Analysis of the scientific literature to date demonstrates that there is no congruent trend in the profile of microorganisms causing infections concomitant with COVID-19. Comparison of the prevalence profiles of pathogens causing secondary infections shows inconsistencies even within macro-regions. The diversity of co-infection and superinfection Patterns may reflect the local diversity of microbial species and respective strains, especially those existing in the hospital environment in cases of superinfection. The most frequent pathogens causing secondary infections in hospitalized patients with COVID-19 cited in the references analysed, in order of occurrence, were: Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, Streptococcus pneumoniae and Enterococcus spp. The rates of concomitant infection between SARS-CoV-2 and other pathogens displayed a great disparity among research conducted in various countries, ranging from 1.2% to 94.2%. Prior knowledge of the microbial agents that cause the most prevalent hospital infections in each Healthcare Unit and the profiles of resistance or sensitivity to antibacterials and antifungals may be of great use in the management of patients presenting with concomitant infections to COVID-19.

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