Co-infections in COVID-19 patients and the importance of microbial diagnosis for disease management

Research article: Co-infections in COVID-19 patients and the importance of microbial diagnosis for disease management

Authors: R. Khalilov1,2,3, A. Eftekhari 2,4, H. Hosainzadegan2,4*

1 Department of Biophysics and Biochemistry, Baku State University, 23 academician Z.Khalilov Str., Baku AZ1148, Azerbaijan

2Joint Ukraine-Azerbaijan International Research and Education Center of Nanobiotechnology and Functional Nanosystems, Drohobych, Ukraine & Baku, Azerbaijan

3Institute of Radiation Problems, Azerbaijan National Academy of Sciences, 9 B.Vahabzadeh Str., Baku AZ1143, Azerbaijan

4Pharmacology and Toxicology Department, Maragheh University of Medical Sciences, Maragheh, Iran

* For correspondence: hasanhosainy122@yahoo.com

Received 12 October 2020; Received in revised form 25 November 2020; Accepted 26 November 2020

Abstract: 

Patients infected with respiratory viral infections especially new coronavirus disease (COVID-19) are most susceptible to co-infections which in turn, increases the severity of disease and mortalities. Therefore, antibiotic agents should be applied for the treatment of bacterial co-infection and super- infections. On the other side, all guidelines for COVID-19 clearly mention that improper use of anti- biotics, especially the combination of broad-spectrum antibiotic agents, should be avoided. Because the use of broad-spectrum antibiotics for a long time and in the combination of several other agents not only shows no effect on the recovery of the disease but also may lead to potentially fatal secondary superinfections and induce resistance in the normal bacterial population. Currently, due to the una- voidable use of antibiotics among patients with COVID-19 who are admitted to intensive care units, cultivation-based methods for isolating and detecting bacteria are less sensitive in the management of the disease. Hence, the use of culture-independent methods that can detect a wide range of potential pathogens and antimicrobial resistance is important, especially for screening and treatment follow- ups. So, culture-independent techniques such as whole-genome metagenomics can be used to identify monomicrobial or mixed infections without selecting the previous target. Whole-genome meta- genomics can provide valuable and useful information about pathogens that cause co-infections and antimicrobial resistance in hospital settings, especially in the intensive care units. Therefore, these studies can have a valuable aid in the management of antibiotic administration and subsequent tar- geted treatment of infections.

Keywords: COVID-19, bacterial infection, antimicrobial, whole-genome metagenomics

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