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Precautions Are Needed for COVID-19 Patients with Coinfection of Common Respiratory Pathogens

24 Pages Posted: 12 Mar 2020

See all articles by Quansheng Xing

Quansheng Xing

Qingdao University - Qingdao Women and Children’s Hospital

Guo-ju Li

Qingdao University - Qingdao Women and Children’s Hospital

Yu-han Xing

The Chinese University of Hong Kong (CUHK) - Department of Paediatrics

Ting Chen

Wuhan University - Department of Ophthalmology

Wen-jie Li

Qingdao Women & Children Hospital

Wei Ni

Qingdao University - Qingdao Women and Children’s Hospital

Kai Deng

Qingdao Chest Hospital

Ru-qin Gao

Qingdao Institute of Prevention Medicine - Qingdao Municipal Centre for Disease Control and Prevention

Chang-zheng Chen

The Chinese University of Hong Kong (CUHK) - Department of Paediatrics

Yang Gao

Qingdao University - Qingdao Women and Children’s Hospital

Qiang Li

Qingdao University - Qingdao Women and Children’s Hospital

Gui-ling Yu

Qingdao University - Qingdao Women and Children’s Hospital

Jian-ning Tong

Qingdao University - Qingdao Women and Children’s Hospital

Wei Li

Qingdao University - Qingdao Women and Children’s Hospital

Gui-liang Hao

Qingdao University - Qingdao Women and Children’s Hospital

Yue Sun

Qingdao University - Qingdao Women and Children’s Hospital

Ai Zhang

Qingdao University - Qingdao Women and Children’s Hospital

Qin Wu

Qingdao University - Qingdao Women and Children’s Hospital

Zi-pu Li

Qingdao University - Qingdao Women and Children’s Hospital

Si-lin Pan

Qingdao University - Qingdao Women and Children’s Hospital

More...

Abstract

Background: With the ongoing outbreak of Coronavirus Disease 2019 (COVID-19), infected patients within and beyond the epidemic area, Wuhan, China, showed different epidemiological and clinical characteristics. Little is known about the pattern of coinfection with other common respiratory pathogens in COVID-19 patients outside of Wuhan.

Methods: We conducted a double-centre study recruiting 68 patients with severe acute respiratory coronavirus 2 (SARS-CoV-2) infection confirmed by nucleic acid testing in Qingdao and Wuhan from January 17 to February 16, 2020. Indirect immuno-fluorescence was performed to detect the specific IgM antibody against common respiratory pathogens in collected acute phase serum.

Findings: Of the 68 patients with SARS-CoV-2 infection, 30 (44.12%) were from Qingdao. The median age of Qingdao and Wuhan patients were 50 (IQR: 37-59) and 31 (IQR: 28-38) years, respectively, and the majority of patients were female in Qingdao (60.00%) and Wuhan (55.26%). Among COVID-19 patients in Qingdao, 24 (80.00%) of them had IgM antibodies against at least one respiratory pathogen, whereas only one (2.60%) of the patients in Wuhan had positive results for serum IgM antibody detection ( P <0.0001). The most common respiratory pathogens detected in Qingdao COVID-19 patients were influenza virus A (60.00%) and influenza virus B (53.30%), followed by mycoplasma pneumoniae (23.30%) and legionella pneumophila (20.00%). While the pattern for coinfection in patients with community-acquired pneumonia in Qingdao was quite different, with a positive rate of only 8.96%.

Interpretation: We reported a large proportion of COVID-19 patients with coinfection of seasonal respiratory pathogens in Qingdao, northeast China, which differed greatly from the patients in Wuhan, central China. Precautions are needed when dealing with COVID-19 patients beyond the epidemic centre who have coinfection with other respiratory pathogens. We highly recommend adding SARS-CoV-2 to routine diagnostic testing in capable hospitals to prevent misdetection of the virus.

Funding Statement: This work is supported by The National Natural Science Foundation of China (NSFC) [Grant number 81770315]; and Distinguished Taishan Scholars (2019).

Declaration of Interests: The authors have no conflict of interest to declare.

Ethics Approval Statement: This study was approved by the Ethics Commission of each participating hospital (QFFLL-KY-2020-11) and written informed consent was obtained from involved patients prior to enrolment.

Keywords: Severe acute respiratory coronavirus 2; Coronavirus Disease 2019; Coinfection; Respiratory pathogen

Suggested Citation

Xing, Quansheng and Li, Guo-ju and Xing, Yu-han and Chen, Ting and Li, Wen-jie and Ni, Wei and Deng, Kai and Gao, Ru-qin and Chen, Chang-zheng and Gao, Yang and Li, Qiang and Yu, Gui-ling and Tong, Jian-ning and Li, Wei and Hao, Gui-liang and Sun, Yue and Zhang, Ai and Wu, Qin and Li, Zi-pu and Pan, Si-lin, Precautions Are Needed for COVID-19 Patients with Coinfection of Common Respiratory Pathogens (3/2/2020). Available at SSRN: https://ssrn.com/abstract=3550013 or http://dx.doi.org/10.2139/ssrn.3550013

Quansheng Xing (Contact Author)

Qingdao University - Qingdao Women and Children’s Hospital ( email )

Shandong
China

Guo-ju Li

Qingdao University - Qingdao Women and Children’s Hospital

Shandong
China

Yu-han Xing

The Chinese University of Hong Kong (CUHK) - Department of Paediatrics

China

Ting Chen

Wuhan University - Department of Ophthalmology

Wuhan
China

Wen-jie Li

Qingdao Women & Children Hospital

China

Wei Ni

Qingdao University - Qingdao Women and Children’s Hospital

Shandong
China

Kai Deng

Qingdao Chest Hospital

Shandong
China

Ru-qin Gao

Qingdao Institute of Prevention Medicine - Qingdao Municipal Centre for Disease Control and Prevention

Qingdao City
China

Chang-zheng Chen

The Chinese University of Hong Kong (CUHK) - Department of Paediatrics

China

Yang Gao

Qingdao University - Qingdao Women and Children’s Hospital

Shandong
China

Qiang Li

Qingdao University - Qingdao Women and Children’s Hospital

Shandong
China

Gui-ling Yu

Qingdao University - Qingdao Women and Children’s Hospital

Shandong
China

Jian-ning Tong

Qingdao University - Qingdao Women and Children’s Hospital

Shandong
China

Wei Li

Qingdao University - Qingdao Women and Children’s Hospital

Shandong
China

Gui-liang Hao

Qingdao University - Qingdao Women and Children’s Hospital

Shandong
China

Yue Sun

Qingdao University - Qingdao Women and Children’s Hospital

Shandong
China

Ai Zhang

Qingdao University - Qingdao Women and Children’s Hospital

Shandong
China

Qin Wu

Qingdao University - Qingdao Women and Children’s Hospital

Shandong
China

Zi-pu Li

Qingdao University - Qingdao Women and Children’s Hospital

Shandong
China

Si-lin Pan

Qingdao University - Qingdao Women and Children’s Hospital

Shandong
China

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