{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:26:12Z","timestamp":1791678372532,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T00:00:00Z","timestamp":1618790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Co\u2010infections, secondary bacterial or fungal infections, are important risk factors for poor outcomes in viral infections. The prevalence of co\u2010infection and secondary infection in patients infected with SARS\u2010CoV\u20102 is not well understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate the role of co\u2010infections and secondary infections in disease severity of hospitalized individuals with COVID\u201019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A retrospective study was carried out between 11 January 2020 and 1 March 2020 among 408 laboratory confirmed COVID\u201019 patients in China. These patients were divided into three groups based on disease severity: mild or moderate, severe, or critically ill. Microbiological pathogens in blood, urine, and respiratory tract specimens were detected by the combination of culture, serology, polymerase chain reaction, and metagenomic next\u2010generation sequencing (mNGS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age of participants was 48 years (IQR 34\u201360 years). Fifty\u2010two patients (12.7%) had at least one additional pathogen, 8.1% were co\u2010infected, and 5.1% had a secondary infection. There were 13 <jats:italic>Mycoplasma pneumoniae<\/jats:italic> cases, 8 <jats:italic>Haemophilus influenzae<\/jats:italic> cases, 8 respiratory viruses, and 3 <jats:italic>Streptococcus pneumoniae<\/jats:italic> cases, primarily detected in mild and moderate COVID\u201019 patients. Hospital\u2010acquired infection pathogens were more common in critically ill patients. Compared to those without additional pathogens, patients with co\u2010infections and\/or secondary infections were more likely to receive antibiotics (<jats:italic>p<\/jats:italic> &lt; 0.001) and have elevated levels of d\u2010dimer (<jats:italic>p<\/jats:italic> = 0.0012), interleukin\u20106 (<jats:italic>p<\/jats:italic> = 0.0027), and procalcitonin (<jats:italic>p<\/jats:italic> = 0.0002). The performance of conventional culture was comparable with that of mNGS in diagnosis of secondary infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Co\u2010infections and secondary infections existed in hospitalized COVID\u201019 patients and were relevant to the disease severity. Screening of common respiratory pathogens and hospital infection control should be strengthened.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.13369","type":"journal-article","created":{"date-parts":[[2021,4,5]],"date-time":"2021-04-05T15:14:56Z","timestamp":1617635696000},"page":"815-825","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Clinical and etiological analysis of co\u2010infections and secondary infections in COVID\u201019 patients: An observational study"],"prefix":"10.1111","volume":"15","author":[{"given":"Shuyan","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory Shenzhen Third People's Hospital, Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Shenzhen Third People's Hospital, Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyu","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Shenzhen Third People's Hospital, Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Shenzhen Third People's Hospital, Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaofang","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Shenzhen Third People's Hospital, Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Shenzhen Third People's Hospital, Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiuxin","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Shenzhen Third People's Hospital, Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"e_1_2_13_3_1","unstructured":"World Health Organization.Weekly operational update on COVID\u201019 \u2010 30 October 2020. 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