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Pneumococcal superinfection in COVID-19 patients: A series of 5 cases

  • Cucchiari, David1
  • Pericàs, Juan M.2, 3
  • Riera, Josep4
  • Gumucio, Roberto5
  • Md, Emmanuel Coloma6, 7, 8
  • Nicolás, David6, 7, 8
  • 1 Renal Transplantation Unit, Nephrology Service, Hospital Clinic Barcelona, Spain
  • 2 Infectious Disease Service, Hospital Clínic Barcelona, Spain
  • 3 Vall d’Hebron Institute for Research (VHIR), Barcelona, Spain
  • 4 Dermatology Service, Hospital Clinic Barcelona, Spain
  • 5 Rheumatology Service, Hospital Clinic Barcelona, Spain
  • 6 Hospital at Home Unit, Medical and Nurse Direction, Internal Medicine Service, Hospital Clinic Barcelona, Spain
  • 7 Universitat de Barcelona, Barcelona, Spain
  • 8 Institut d’Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
Published Article
Medicina Clínica
Publication Date
Jun 05, 2020
DOI: 10.1016/j.medcli.2020.05.022
PMID: 32591180
PMCID: PMC7274636
PubMed Central


Background In the context of the COVID-19 pandemic the risk of misdiagnosis of other causes of respiratory infection is likely. In this work we aim to describe the clinical characteristics, treatment and outcome of pneumococcal infection in COVID-19 patients. Patients and methods Every COVID-19 patient presenting with concomitant pneumococcal pneumonia during March 2020 in a tertiary teaching Hospital In Barcelona, Spain. Results Five patients with PCR confirmed COVID19 or clinical and radiological suspicion were diagnosed of pneumococcal infection. In all cases chest X-ray were abnormal, with unilateral or bilateral infiltrates. Procalcitonin showed to be not sensitive enough to detect pneumococcal infection. Antibiotherapy was promptly started in all five cases with subsequent satisfactory evolution. Conclusion International guidelines do not include the universal screening for bacterial co-infection. Radiological pattern of COVID-19 can be indistinguishable from that of pneumococcus pneumonia and frequency of co-infection is not well stablished, therefore clinicians should be aware of the possible SARS-CoV-2-pneumococcus association to avoid misdiagnosis and delay antibiotic therapy.

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