The microbial coinfection in COVID-19

Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, Oczkowski S, Levy MM, Derde L, Dzierba A, Du B, Aboodi M, Wunsch H, Cecconi M, Koh Y, Chertow DS, Maitland K, Alshamsi F, Belley-Cote E, Greco M, Laundy M, Morgan JS, Kesecioglu J, McGeer A, Mermel L, Mammen MJ, Alexander PE, Arrington A, Centofanti JE, Citerio G, Baw B, Memish ZA, Hammond N, Hayden FG, Evans L, Rhodes A (2020) Surviving sepsis campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med 46(5):854–887. https://doi.org/10.1007/s00134-020-06022-5 Årdal C, Balasegaram M, Laxminarayan R, McAdams D, Outterson K, Rex JH, Sumpradit N (2020) Antibiotic development - economic, regulatory and societal challenges. Nat Rev Microbiol 18(5):267–274. https://doi.org/10.1038/s41579-019-0293-3 Aslam B, Wang W, Arshad MI, Khurshid M, Muzammil S, Rasool MH, Nisar MA, Alvi RF, Aslam MA, Qamar MU, Salamat MKF, Baloch Z (2018) Antibiotic resistance: a rundown of a global crisis. Infect Drug Resist 11:1645–1658. https://doi.org/10.2147/idr.S173867 Azekawa S, Namkoong H, Mitamura K, Kawaoka Y, Saito F (2020) Co-infection with SARS-CoV-2 and influenza A virus. IDCases 20:e00775. https://doi.org/10.1016/j.idcr.2020.e00775 Azoulay E, Russell L, Van de Louw A, Metaxa V, Bauer P, Povoa P, Montero JG, Loeches IM, Mehta S, Puxty K, Schellongowski P, Rello J, Mokart D, Lemiale V, Mirouse A (2020) Diagnosis of severe respiratory infections in immunocompromised patients. Intensive Care Med 46(2):298–314. https://doi.org/10.1007/s00134-019-05906-5 Bassetti M, Giacobbe DR, Aliberti S, Barisione E, Centanni S, De Rosa FG, Di Marco F, Gori A, Granata G, Mikulska M, Petrosillo N, Richeldi L, Santus P, Tascini C, Vena A, Viale P, Blasi F (2020) Balancing evidence and frontline experience in the early phases of the COVID-19 pandemic: current position of the Italian Society of anti-infective therapy (SITA) and the Italian Society of Pulmonology (SIP). Clin Microbiol Infect 26(7):880–894. https://doi.org/10.1016/j.cmi.2020.04.031 Bengoechea JA, Bamford CGG (2020) SARS-CoV-2, bacterial co-infections, and AMR: the deadly trio in COVID-19? EMBO Mol Med doi:10.15252/emmm.202012560 Blanco JL, Ambrosioni J, Garcia F, Martínez E, Soriano A, Mallolas J, Miro JM (2020) COVID-19 in patients with HIV: clinical case series. Lancet HIV 7(5):e314–e316. https://doi.org/10.1016/s2352-3018(20)30111-9 Boeckmans J, Rodrigues RM, Demuyser T, Piérard D, Vanhaecke T, Rogiers V (2020) COVID-19 and drug-induced liver injury: a problem of plenty or a petty point? Arch Toxicol 94(4):1367–1369. https://doi.org/10.1007/s00204-020-02734-1 Brockmeier SL, Loving CL, Nicholson TL, Palmer MV (2008) Coinfection of pigs with porcine respiratory coronavirus and Bordetella bronchiseptica. Vet Microbiol 128(1-2):36–47. https://doi.org/10.1016/j.vetmic.2007.09.025 Budayanti NS, Suryawan K, Iswari IS, Sukrama DM (2019) The quality of sputum specimens as a predictor of isolated bacteria from patients with lower respiratory tract infections at a tertiary referral hospital, Denpasar, Bali-Indonesia. Front Med (Lausanne) 6:64. https://doi.org/10.3389/fmed.2019.00064 Castagnoli R, Votto M, Licari A, Brambilla I, Bruno R, Perlini S, Rovida F, Baldanti F, Marseglia GL (2020) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents: a systematic review. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2020.1467 Cawcutt K, Kalil AC (2017) Pneumonia with bacterial and viral coinfection. Curr Opin Crit Care 23(5):385–390. https://doi.org/10.1097/mcc.0000000000000435 Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L (2020) Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 395(10223):507–513. https://doi.org/10.1016/s0140-6736(20)30211-7 Choi SH, Hong SB, Ko GB, Lee Y, Park HJ, Park SY, Moon SM, Cho OH, Park KH, Chong YP, Kim SH, Huh JW, Sung H, Do KH, Lee SO, Kim MN, Jeong JY, Lim CM, Kim YS, Woo JH, Koh Y (2012) Viral infection in patients with severe pneumonia requiring intensive care unit admission. Am J Respir Crit Care Med 186(4):325–332. https://doi.org/10.1164/rccm.201112-2240OC Danis K, Epaulard O, Bénet T, Gaymard A, Campoy S, Bothelo-Nevers E, Bouscambert-Duchamp M, Spaccaferri G, Ader F, Mailles A, Boudalaa Z, Tolsma V, Berra J, Vaux S, Forestier E, Landelle C, Fougere E, Thabuis A, Berthelot P, Veil R, Levy-Bruhl D, Chidiac C, Lina B, Coignard B, Saura C (2020) Cluster of coronavirus disease 2019 (Covid-19) in the French Alps, 2020. Clin Infect Dis 71:825–832. https://doi.org/10.1093/cid/ciaa424 D'Cruz RJ, Currier AW, Sampson VB (2020) Laboratory testing methods for novel severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Front Cell Dev Biol 8:468. https://doi.org/10.3389/fcell.2020.00468 Denney L, Ho LP (2018) The role of respiratory epithelium in host defence against influenza virus infection. Biomed J 41(4):218–233. https://doi.org/10.1016/j.bj.2018.08.004 Ferretti L, Wymant C, Kendall M, Zhao L, Nurtay A, Abeler-Dörner L, Parker M, Bonsall D, Fraser C (2020) Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing. Science 368(6491):eabb6936. https://doi.org/10.1126/science.abb6936 Garazzino S, Montagnani C, Donà D, Meini A, Felici E, Vergine G, Bernardi S, Giacchero R, Lo Vecchio A, Marchisio P, Nicolini G, Pierantoni L, Rabbone I, Banderali G, Denina M, Venturini E, Krzysztofiak A, Badolato R, Bianchini S, Galli L, Villani A, Castelli-Gattinara G, The Italian Sitip-Sip pediatric infection study G (2020) Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at 10 April 2020. Euro Surveill 25(18). https://doi.org/10.2807/1560-7917.Es.2020.25.18.2000600 Gu J, Korteweg C (2007) Pathology and pathogenesis of severe acute respiratory syndrome. Am J Pathol 170(4):1136–1147. https://doi.org/10.2353/ajpath.2007.061088 Gu S, Chen Y, Wu Z, Chen Y, Gao H, Lv L, Guo F, Zhang X, Luo R, Huang C, Lu H, Zheng B, Zhang J, Yan R, Zhang H, Jiang H, Xu Q, Guo J, Gong Y, Tang L, Li L (2020) Alterations of the gut microbiota in patients with COVID-19 or H1N1 influenza. Clinical Infectious Diseases. https://doi.org/10.1093/cid/ciaa709 Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B (2020) Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet 395(10223):497–506. https://doi.org/10.1016/S0140-6736(20)30183-5 Huttner B, Catho G, Pano-Pardo JR, Pulcini C, Schouten J (2020) COVID-19: don’t neglect antimicrobial stewardship principles! Clin Microbiol Infect 26(7):808–810. https://doi.org/10.1016/j.cmi.2020.04.024 Kalantar-Zadeh K, Ward SA, Kalantar-Zadeh K, El-Omar EM (2020) Considering the effects of microbiome and diet on SARS-CoV-2 infection: nanotechnology roles. ACS Nano 14(5):5179–5182. https://doi.org/10.1021/acsnano.0c03402 Kiedrowski MR, Bomberger JM (2018) Viral-bacterial co-infections in the cystic fibrosis respiratory tract. Front Immunol 9:3067. https://doi.org/10.3389/fimmu.2018.03067 Kiley JL, Chung KK, Blyth DM (2020) Viral infections in burns. Surg Infect (Larchmt). https://doi.org/10.1089/sur.2020.130 Kim D, Quinn J, Pinsky B, Shah NH, Brown I (2020) Rates of Co-infection Between SARS-CoV-2 and Other Respiratory Pathogens. Jama 323:2085. https://doi.org/10.1001/jama.2020.6266 Klein EY, Monteforte B, Gupta A, Jiang W, May L, Hsieh YH, Dugas A (2016) The frequency of influenza and bacterial coinfection: a systematic review and meta-analysis. Influenza Other Respir Viruses 10(5):394–403. https://doi.org/10.1111/irv.12398 Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR (2020a) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents 55(3):105924. https://doi.org/10.1016/j.ijantimicag.2020.105924 Lai CC, Wang CY, Hsueh PR (2020b) Co-infections among patients with COVID-19: The need for combination therapy with non-anti-SARS-CoV-2 agents? J Microbiol Immunol Infect. https://doi.org/10.1016/j.jmii.2020.05.013 Li Z, He L, Li S, He W, Zha C, Ou W, Hou Q, Wang W, Sun X, Liang H (2019) Combination of procalcitonin and C-reactive protein levels in the early diagnosis of bacterial co-infections in children with H1N1 influenza. Influenza Other Respir Viruses 13(2):184–190. https://doi.org/10.1111/irv.12621 Li R, Pei S, Chen B, Song Y, Zhang T, Yang W, Shaman J (2020a) Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science 368(6490):489–493. https://doi.org/10.1126/science.abb3221 Li X, Wang L, Yan S, Yang F, Xiang L, Zhu J, Shen B, Gong Z (2020b) Clinical characteristics of 25 death cases with COVID-19: a retrospective review of medical records in a single medical center, Wuhan, China. Int J Infect Dis 94:128–132. https://doi.org/10.1016/j.ijid.2020.03.053 Li Y, Ren B, Peng X, Hu T, Li J, Gong T, Tang B, Xu X, Zhou X (2020c) Saliva is a non-negligible factor in the spread of COVID-19. Mol Oral Microbiol 35:141–145. https://doi.org/10.1111/omi.12289 Lim YK, Kweon OJ, Kim HR, Kim TH, Lee MK (2019) Impact of bacterial and viral coinfection in community-acquired pneumonia in adults. Diagn Microbiol Infect Dis 94(1):50–54. https://doi.org/10.1016/j.diagmicrobio.2018.11.014 Lin D, Liu L, Zhang M, Hu Y, Yang Q, Guo J, Guo Y, Dai Y, Xu Y, Cai Y, Chen X, Zhang Z, Huang K (2020) Co-infections of SARS-CoV-2 with multiple common respiratory pathogens in infected patients. Sci China Life Sci 63(4):606–609. https://doi.org/10.1007/s11427-020-1668-5 Lippi G, Plebani M (2020) Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. Clin Chim Acta 505:190–191. https://doi.org/10.1016/j.cca.2020.03.004 Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, Wang W, Song H, Huang B, Zhu N, Bi Y, Ma X, Zhan F, Wang L, Hu T, Zhou H, Hu Z, Zhou W, Zhao L, Chen J, Meng Y, Wang J, Lin Y, Yuan J, Xie Z, Ma J, Liu WJ, Wang D, Xu W, Holmes EC, Gao GF, Wu G, Chen W, Shi W, Tan W (2020) Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 395(10224):565–574. https://doi.org/10.1016/s0140-6736(20)30251-8 Luo Y, Xie Y, Zhang W, Lin Q, Tang G, Wu S, Huang M, Yin B, Huang J, Wei W, Yu J, Hou H, Mao L, Liu W, Wang F, Sun Z (2019) Combination of lymphocyte number and function in evaluating host immunity. Aging (Albany NY) 11(24):12685–12707. https://doi.org/10.18632/aging.102595 Mahony JB (2008) Detection of respiratory viruses by molecular methods. Clin Microbiol Rev 21(4):716–747. https://doi.org/10.1128/cmr.00037-07 Martins-Filho PR, Tavares CSS, Santos VS (2020) Factors associated with mortality in patients with COVID-19. A quantitative evidence synthesis of clinical and laboratory data. Eur J Intern Med 76:97–99. https://doi.org/10.1016/j.ejim.2020.04.043 Netea MG, Giamarellos-Bourboulis EJ, Domínguez-Andrés J, Curtis N, van Crevel R, van de Veerdonk FL, Bonten M (2020) Trained immunity: a tool for reducing susceptibility to and the severity of SARS-CoV-2 infection. Cell 181(5):969–977. https://doi.org/10.1016/j.cell.2020.04.042 Ni L, Ye F, Cheng ML, Feng Y, Deng YQ, Zhao H, Wei P, Ge J, Gou M, Li X, Sun L, Cao T, Wang P, Zhou C, Zhang R, Liang P, Guo H, Wang X, Qin CF, Chen F, Dong C (2020) Detection of SARS-CoV-2-specific humoral and cellular immunity in COVID-19 convalescent individuals. Immunity 52:971–977.e3. https://doi.org/10.1016/j.immuni.2020.04.023 Nickbakhsh S, Mair C, Matthews L, Reeve R, Johnson PCD, Thorburn F, von Wissmann B, Reynolds A, McMenamin J, Gunson RN, Murcia PR (2019) Virus-virus interactions impact the population dynamics of influenza and the common cold. Proc Natl Acad Sci U S A 116(52):27142–27150. https://doi.org/10.1073/pnas.1911083116 Nicola M, O'Neill N, Sohrabi C, Khan M, Agha M, Agha R (2020) Evidence based management guideline for the COVID-19 pandemic - Review article. Int J Surg 77:206–216. https://doi.org/10.1016/j.ijsu.2020.04.001 Nikolich-Zugich J, Knox KS, Rios CT, Natt B, Bhattacharya D, Fain MJ (2020) SARS-CoV-2 and COVID-19 in older adults: what we may expect regarding pathogenesis, immune responses, and outcomes. 10 doi:https://doi.org/10.1007/s11357-020-00186-0 Nowak MD, Sordillo EM, Gitman MR, Paniz Mondolfi AE (2020) Co-infection in SARS-CoV-2 infected patients: where are influenza virus and rhinovirus/enterovirus? J Med Virol. https://doi.org/10.1002/jmv.25953 Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B (2020) Transmission routes of 2019-nCoV and controls in dental practice. Int J Oral Sci 12(1):9. https://doi.org/10.1038/s41368-020-0075-9 Piva S, Filippini M, Turla F, Cattaneo S, Margola A, De Fulviis S, Nardiello I, Beretta A, Ferrari L, Trotta R, Erbici G, Focà E, Castelli F, Rasulo F, Lanspa MJ, Latronico N (2020) Clinical presentation and initial management critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Brescia, Italy. J Crit Care 58:29–33. https://doi.org/10.1016/j.jcrc.2020.04.004 Prestinaci F, Pezzotti P, Pantosti A (2015) Antimicrobial resistance: a global multifaceted phenomenon. Pathog Glob Health 109(7):309–318. https://doi.org/10.1179/2047773215y.0000000030 Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, Xie C, Ma K, Shang K, Wang W, Tian DS (2020) Dysregulation of immune response in patients with COVID-19 in Wuhan. China. Clin Infect Dis 71:762–768. https://doi.org/10.1093/cid/ciaa248 Rawson TM, Moore LSP, Zhu N, Ranganathan N, Skolimowska K, Gilchrist M, Satta G, Cooke G, Holmes A (2020) Bacterial and fungal co-infection in individuals with coronavirus: a rapid review to support COVID-19 antimicrobial prescribing. Clin Infect Dis. https://doi.org/10.1093/cid/ciaa530 Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, Barnaby DP, Becker LB, Chelico JD, Cohen SL, Cookingham J, Coppa K, Diefenbach MA, Dominello AJ, Duer-Hefele J, Falzon L, Gitlin J, Hajizadeh N, Harvin TG, Hirschwerk DA, Kim EJ, Kozel ZM, Marrast LM, Mogavero JN, Osorio GA, Qiu M, Zanos TP (2020) Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. Jama 323:2052. https://doi.org/10.1001/jama.2020.6775 Rodriguez JA, Rubio-Gomez H, Roa AA, Miller N, Eckardt PA (2020) Co-Infection with SARS-COV-2 and Parainfluenza in a young adult patient with pneumonia: case report. IDCases 20:e00762. https://doi.org/10.1016/j.idcr.2020.e00762 Rouse BT, Sehrawat S (2010) Immunity and immunopathology to viruses: what decides the outcome? Nat Rev Immunol 10(7):514–526. https://doi.org/10.1038/nri2802 Ruuskanen O, Lahti E, Jennings LC, Murdoch DR (2011) Viral pneumonia. Lancet 377(9773):1264–1275. https://doi.org/10.1016/s0140-6736(10)61459-6 Salehi M, Ahmadikia K, Mahmoudi S, Kalantari S, Jamalimoghadam Siahkali S, Izadi A, Kord M, Dehghan Manshadi SA, Seifi A, Ghiasvand F, Khajavirad N, Ebrahimi S, Koohfar A, Boekhout T, Khodavaisy S (2020) Oropharyngeal candidiasis in hospitalized COVID-19 Patients from Iran: Species identification and antifungal susceptibility pattern. Mycoses 63:771–778. https://doi.org/10.1111/myc.13137 Shen Z, Xiao Y, Kang L, Ma W, Shi L, Zhang L, Zhou Z, Yang J, Zhong J, Yang D, Guo L, Zhang G, Li H, Xu Y, Chen M, Gao Z, Wang J, Ren L, Li M (2020) Genomic diversity of SARS-CoV-2 in Coronavirus Disease 2019 patients. Clin Infect Dis 71:713–720. https://doi.org/10.1093/cid/ciaa203 Singhal T (2020) A review of coronavirus disease-2019 (COVID-19). Indian J Pediatr 87(4):281–286. https://doi.org/10.1007/s12098-020-03263-6 Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang YQ, Wang Q, Miao H (2020) Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther 5(1):33. https://doi.org/10.1038/s41392-020-0148-4 Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LFP (2020) The trinity of COVID-19: immunity, inflammation and intervention. Nature Reviews Immunology 20:363–374. https://doi.org/10.1038/s41577-020-0311-8 Vareille M, Kieninger E, Edwards MR, Regamey N (2011) The airway epithelium: soldier in the fight against respiratory viruses. Clin Microbiol Rev 24(1):210–229. https://doi.org/10.1128/cmr.00014-10 Verweij PE, Rijnders BJA, Brüggemann RJM, Azoulay E, Bassetti M, Blot S, Calandra T, Clancy CJ, Cornely OA, Chiller T, Depuydt P, Giacobbe DR, Janssen NAF, Kullberg BJ, Lagrou K, Lass-Flörl C, Lewis RE, Liu PW, Lortholary O, Maertens J, Martin-Loeches I, Nguyen MH, Patterson TF, Rogers TR, Schouten JA, Spriet I, Vanderbeke L, Wauters J, van de Veerdonk FL (2020) Review of influenza-associated pulmonary aspergillosis in ICU patients and proposal for a case definition: an expert opinion. Intens Care Med. https://doi.org/10.1007/s00134-020-06091-6 Wang M, Luo L, Bu H, Xia H (2020a) Case report: one case of coronavirus desease 2019(COVID-19) in patient co-nfected by HIV with a low CD4+ T cell count. Int J Infect Dis 96:148–150. https://doi.org/10.1016/j.ijid.2020.04.060 Wang M, Wu Q, Xu W, Qiao B, Wang J, Zheng H, Jiang S, Mei J, Wu Z, Deng Y, Zhou F, Wu W, Zhang Y, Lv Z, Huang J, Guo X, Feng L, Xia Z, Li D, Xu Z, Liu T, Zhang P, Tong Y, Li Y (2020b) Clinical diagnosis of 8274 samples with 2019-novel coronavirus in Wuhan. medRxiv:2020.02.12.20022327 doi:https://doi.org/10.1101/2020.02.12.20022327 Wiegers HMG, van Nijen L, van Woensel JBM, Bem RA, de Jong MD, Calis JCJ (2019) Bacterial co-infection of the respiratory tract in ventilated children with bronchiolitis; a retrospective cohort study. BMC Infectious Diseases 19(1):938. https://doi.org/10.1186/s12879-019-4468-3 World Health O (2020) Laboratory testing for coronavirus disease 2019 (COVID-19) in suspected human cases: interim guidance, 2 March 2020. World Health Organization, Geneva Xu R, Cui B, Duan X, Zhang P, Zhou X, Yuan Q (2020) Saliva: potential diagnostic value and transmission of 2019-nCoV. Int J Oral Sci 12(1):11. https://doi.org/10.1038/s41368-020-0080-z Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, Wu Y, Zhang L, Yu Z, Fang M, Yu T, Wang Y, Pan S, Zou X, Yuan S, Shang Y (2020) Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 8(5):475–481. https://doi.org/10.1016/s2213-2600(20)30079-5 Yetmar ZA, Issa M, Munawar S, Burton MC, Pureza V, Sohail MR, Mehmood T (2020) Inpatient Care of Patients with COVID-19: A Guide for Hospitalists. Am J Med S0002-9343(20):30349–30341. https://doi.org/10.1016/j.amjmed.2020.03.041 Yuen KS, Ye ZW, Fung SY, Chan CP, Jin DY (2020) SARS-CoV-2 and COVID-19: the most important research questions. Cell Biosci 10:40. https://doi.org/10.1186/s13578-020-00404-4 Zhang G, Hu C, Luo L, Fang F, Chen Y, Li J, Peng Z, Pan H (2020) Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan, China. J Clin Virol 127:104364. https://doi.org/10.1016/j.jcv.2020.104364 Zheng Z, Chen R, Li Y, Liu X, He W, Xu Y, He G, Li Y, Luo Q, Zhong N (2003) The clinical characteristics of secondary infections of lower respiratory tract in severe acute respiratory syndrome. Chinese Journal of Respiratory and Critical Care Medicine 2(5):270–274 Zhou P, Liu Z, Chen Y, Xiao Y, Huang X, Fan XG (2020a) Bacterial and fungal infections in COVID-19 patients: a matter of concern. Infect Control Hosp Epidemiol:1-2 doi:https://doi.org/10.1017/ice.2020.156 Zhou S, Wang Y, Zhu T, Xia L (2020b) CT features of Coronavirus Disease 2019 (COVID-19) pneumonia in 62 patients in Wuhan, China. AJR Am J Roentgenol 214(6):1287–1294. https://doi.org/10.2214/ajr.20.22975 Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W (2020) A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 382(8):727–733. https://doi.org/10.1056/NEJMoa2001017 Zuo T, Zhan H, Zhang F, Liu Q, Tso EYK, Lui GCY, Chen N, Li A, Lu W, Chan FKL, Chan PKS, Ng SC (2020) Alterations in fecal fungal microbiome of patients with COVID-19 during time of hospitalization until discharge. Gastroenterology. https://doi.org/10.1053/j.gastro.2020.06.048