Coinfections in COVID-19

What organisms are you seeing clinically?

This is potentially going to be quite an anecdotal thread and secondary infections/co-infections might vary by location, treatment, the patient cohort that your centres usually treat, but with all those usual caveats: what organisms are you seeing? Are you detecting many? Lots?

Inspired by @Jose’s post here Research Projects

Don’t see many secondary infections in patients managed solely on COVID wards as usually their stay is short (get better quickly or have an unfortunate outcome). Most of these occur in ITU in ventilated patients. Either microbiology or infectious diseases teams would have this datasets.

What we see on wards are patients with other infections including strep pneumonia succumbing to COVID-19 that often may be acquired whilst in hospital.

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ISARIC data so far seems to indicate stays on mechanical ventilation on average are 9 days +/- 5 which seems fairly substantial, so this would be considered VAP rather than a secondary infection?

I’m always cautious about labels like VAP as microbiologically unless you test frequently from admission, you don’t really know if that organism was lurking about before ventilation. As it’s defined by timing, it could vary quite a lot from bug to bug as it’s a growth thing.

Is testing for bacteria being done, would there be a swab on admission or sputum culture if produced as a matter of course alongside COVID-19 qPCR or would this require additional clinical indications?

Sputum often sent with swab for Covid detection, but most patients have a dry cough. ITU however routinely send off tracheal secretions in intubated patients with Covid so you are very likely to find signals of co-infections from their microbiology clinical datasets.

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Hi all, I have a friend who works as a medical technologist in the USA, and she’s mentioned that (anecdotally) they have been noticing some blood clotting in a number of patients. Was this observed here in the UK too? And if so, would there be anything (secodary infection or otherwise) that would be causing this blood clot? I would imagine this would be a huge factor for severe disease.

…I mean other than cardiovascular diseases like hypertension, etc. Basically what I’d like to ask is if there’s anything unusual about the blood clotting that is not linked to patient history?

It looks like it is a thing

https://edition.cnn.com/2020/04/22/health/strokes-coronavirus-young-adults/index.html

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We recently reported a case of Panton-Valentine Leukocidin-Secreting Staphylococcus aureus pneumonia complicating COVID-19 ( https://wwwnc.cdc.gov/eid/article/26/8/20-1413_article ). However, it is not frequent in our hospital.

Co-infections are mainly bacteria associated with VAP in ICU patients (Pseudomonas aeruginosa, Enterobacterales).

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There is one dude on twitter pushing for a theory that covid-19 is because of Prevotella and how SARS-COV-2 gets inserted into the genome of Prevotella. Tried engaging but of no use. Anyways, he’s adding fuel to more misinformation for folks to take more antibiotics. A thread of others trying to help-> to stopping the misinformation

Thanks Vivek, yeah I have engaged too to point out Prevotella is a very common respiratory bug and that he has found a chimeric read.

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:rotating_light: Emerging Issue Alert! :rotating_light:

I saw this tweet from the PICSUK, talking about possible Covid19 issues in children of all ages:

“There is a growing concern that a SARS-Cov-2 related inflammatory syndrome emerging in children in the UK or that there may be another as yet unidentified infectious pathogen associated with these cases.

As yet, cases have been thought to be rare. Weirdly enough, the same friend of mine who is a Medical Technologist in the US also said she was increasingly seeing a lot of samples from children.

Personally, I wish the tweet/info has been packed/disseminated in another way - I can already see the panic this is going to cause a lot of people (I myself panicked too), especially parents. This is also gold for a lot of conspiracy theorists too.

Anyways, any thoughts about this?

Not entirely sure whether this is the best forum to place this, but below is an ad for a meeting which discusses COVID19 in children