Introduction
Cases description
Pt | Age/sex | Comorbidities | Clinical presentation | Type of co-infection | Laboratory findings on admission | Oxygen delivery | Therapy | ICU/death | Lenght of hospitalization, days |
---|---|---|---|---|---|---|---|---|---|
Pt#1 | 86/F | Hypertension, diabetes | Fever, altered mental status | M. pneumoniae | WBC 4850 N/L 2820/1330 PLT 198,000 CRP 0.25 LDH 207 D-dimer 4473 | Room air | Hydroxychloroquine, azithromycin, heparin | No/No | 32 |
Pt#2 | 19/M | None | Fever, cough | M. pneumoniae | WBC 5250 N/L 4470/520 PLT 127,000 CRP 11.01 LDH 556 D-dimer 383 | C-PAP and high-flow nasal cannula | Hydroxychloroquine, azithromycin, teicoplanin, tocilizumab, corticosteroid, heparin, piperacillin/tazobactam | Yes/No | 41 |
Pt#3 | 73/F | Congestive heart failure, bronchial asthma, chronic renal failure | Fever, cough, shortness of breath, fatigue | C. pneumoniae | WBC 4850 N/L 46,560/1740 PLT 223,000 CRP 10.05 LDH 308 D-dimer 4473 | Venturi mask | Lopinavir/ritonavir, hydroxychloroquine, azithromycin, heparin, piperacillin/tazobactam | No/No | 21 |
Pt#4 | 45/F | None | Fever, shortness of breath, chest pain | C. pneumoniae | WBC 7590 N/L 4240/2470 PLT 208,000 CRP 0.16 LDH 158 D-dimer 234 | Room air | Hydroxychloroquine, azithromycin, corticosteroid, heparin | No/No | 13 |
Pt#5 | 77/M | Hypertension, diabetes | Fever, myalgia | C. pneumoniae | WBC 7390 N/L 6240/700 PLT 206,000 CRP 9.4 LDH 416 D-dimer 3170 | C-PAP | Hydroxychloroquine, azithromycin, tocilizumab, corticosteroid, ceftriaxone | No/No | 28 |
Pt#6 | 79/M | Congestive heart failure, bronchial asthma | Shortness of breath | C. pneumoniae | WBC 16,170 N/L 14,310/1130 PLT 76,000 CRP 0.51 LDH 371 D-dimer 4382 | Venturi mask | Hydroxychloroquine, azithromycin | No/No | 34 |
Pt#7 | 60/M | None | Fever, cough | C. pneumoniae | WBC 8440 N/L 7260/840 PLT 216,000 CRP 3.27 LDH 239 D-dimer 581 | Venturi mask | Lopinavir/ritonavir, hydroxychloroquine, azithromycin | No/No | 7 |
Discussion and review of the literature
Author | Type of study | Type of patients | Overall rate of co-infection | Type of M. pneumoniae or C. pneumoniae co-infection | Diagnostic method of co-infection | Number of patients with M. pneumoniae or C. pneumoniae co-infection | Outcome |
---|---|---|---|---|---|---|---|
Blasco et al. [4] | Retrospective study in patients with SARS-CoV-2 infection at Clinic University Hospital of Valencia | Adults | 3/103 (2.9%) | M. pneumoniae | Multiplex PCR assay | 1/103 (0.97%) M. pneumoniae | NA |
Xing et al. [6] | Double-centre study in China (Qingdao and Wuhan regions) in patients with SARS-CoV-2 infection | Adults | 25/68 (36.7%) 24/30 (80%) Qingdao 1/38 (2.63%) Wuhan | M. pneumoniae | Serology | 8/68 (11.7%) M. pneumoniae 7/30 (23.3%) Qingdao 1/38 (2.63%) Wuhan | NA |
Easom et al. [10] | First 68 patients with SARS-CoV-2 infection at a Regional Infectious Diseases Unit (RIDU) in the UK | Adults | 29/67 (43.2%) | M. pneumoniae | Multiplex PCR assay | 1/67 (1.49%) M. pneumoniae | NA |
Zhang et al. [9] | Hospitalized patients with SARS-CoV-2 infection in No. 7 Hospital of Wuhan | Adults | 7/58 (12.0%) | M. pneumoniae | Serology | 5/58 (8.6%) M. pneumoniae | NA |
Wu et al. [12] | Pediatric patients with laboratory-confirmed COVID-19 at Qingdao Women’s and Children’s Hospital and Wuhan Children’s Hospital | Pediatrics | 19/34 (55.88%) | M. pneumoniae | Multiplex PCR assay | 16/34 (47.0%) M. pneumoniae M. pneumoniae alone = 11; M. pneumoniae + RSV = 2 M. pneumoniae + EBV = 2 M. pneumoniae + RSV + InfluenzaA/B = 1 | Survived |
Gayam et al. [11] | Out of 350 patients hospitalized with SARS-CoV-2 infection at Interfaith Medical Center, Brooklyn, New York, a series of six patients with co-infection from SARS-CoV-2 and M. pneumoniae | Adults | 6/350 (1.71%) | M. pneumoniae | Serology | 6/350 (1.71%) M. pneumoniae | 1/6 (16.6%) ICU admission and death |
Fan et al. [13] | Case report | Adult (36-year old male) | NA | M. pneumoniae | Cold agglutinin titer of 1:8 with a M. pneumoniae antibody titer of 1:160 | NA | ICU admission |
Gao et al. [15] | Case report | Adult (49-year old female) | NA | M. pneumoniae | Serology | NA | Recovery |
Chen et al. [14] | Case report | Pediatric (12-year-old boy) | NA | M. pneumoniae | Serology | NA | Recovery |
Richardson et al. [16] | All consecutive hospitalized patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at any of 12 Northwell Health acute care hospitals between March 1, 2020 and April 4, 2020 | Adults | 42/1996 (2.1%) | C. pneumoniae | Respiratory pathogens panel | 2/42 (4.76%) C. pneumoniae | NA |