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Pneumococcal superinfection in COVID-19 patients: A series of 5 cases

David Cucchiari1, Juan M Pericàs2,3, Josep Riera4

  • 1Renal Transplantation Unit, Nephrology Service, Hospital Clinic Barcelona, Spain.

Medicina Clinica (English Ed.)
|February 1, 2021
PubMed
Abstract

Insights

Pneumococcal infection can co-occur with COVID-19, presenting similar symptoms. Early antibiotic therapy is crucial for favorable outcomes in these coinfected patients.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Critical Care Medicine

Background:

  • The COVID-19 pandemic heightened the risk of misdiagnosing other respiratory infections.
  • Distinguishing between COVID-19 and bacterial pneumonia, such as pneumococcal pneumonia, is clinically challenging.
  • This study investigates the characteristics, treatment, and outcomes of pneumococcal infection in patients with COVID-19.

Observation:

  • Five patients with confirmed or suspected COVID-19 also presented with pneumococcal pneumonia.
  • Chest X-rays revealed abnormal unilateral or bilateral infiltrates in all cases.
  • Procalcitonin levels were not sufficiently sensitive to reliably detect pneumococcal infection.

Findings:

  • Prompt initiation of antibiotic therapy led to satisfactory clinical improvement in all five patients.
  • Radiological findings for COVID-19 and pneumococcal pneumonia can be indistinguishable.
  • The frequency of bacterial co-infections in COVID-19 patients remains not well-established.

Implications:

  • Current international guidelines lack universal screening for bacterial co-infections in COVID-19.
  • Clinicians must maintain a high index of suspicion for the SARS-CoV-2-pneumococcus association.
  • Awareness of this co-infection can prevent misdiagnosis and ensure timely antibiotic administration, improving patient outcomes.
Keywords:
COVID-19DiagnosisS. pneumoniaeTreatmentco-infection

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