Evidence map›Paper›PMID 32482366›Full record

ReviewJournal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi2020

Co-infections among patients with COVID-19: The need for combination therapy with non-anti-SARS-CoV-2 agents?

Chih-Cheng Lai, Cheng-Yi Wang, Po-Ren Hsueh

Open access · goldAbstract readReview
In one paragraph

Review in Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 273 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
273citing papers in PubMed, 2 pooled it
11.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

273 citing papers in PubMed, 2 syntheses or guidelines pooled it, 509 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. The Fallacy of a Single Diagnosis.Medical decision making : an international journal of the Society for Medical Decision Making · 2023
    Trial
  4. A comprehensive overview of monkeypox virus disease.Tropical medicine and health · 2026
    Review
  5. Article
  6. Article
  7. Clinical Characteristics and Cytokines of Children With Lower Respiratory Tract Infection Caused by Influenza A After COVID-19.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2026
    Article
  8. Antimicrobial resistance before and after the COVID-19 pandemic in Northern Brazil.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026
    Article
  9. Review
  10. Article
  11. Article
  12. Article
  13. Article
  14. Incidence trends and epidemiology of invasive device-associated bacteremia in French nursing home residents, 2020-2024: Insights from the SPIADI Prospective Multicenter Study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025
    Article
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article

213 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 1 country.

Chih-Cheng LaiDepartment of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan.
Cheng-Yi WangDepartment of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
Po-Ren HsuehDepartments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: hsporen@ntu.edu.tw.
Cardinal Tien Hospital · TWKaohsiung Veterans General Hospital · TWNational Taiwan University Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Co-infection has been reported in patients with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome, but there is limited knowledge on co-infection among patients with coronavirus disease 2019 (COVID-19). The prevalence of co-infection was variable among COVID-19 patients in different studies, however, it could be up to 50% among non-survivors. Co-pathogens included bacteria, such as Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumonia, Legionella pneumophila and Acinetobacter baumannii; Candida species and Aspergillus flavus; and viruses such as influenza, coronavirus, rhinovirus/enterovirus, parainfluenza, metapneumovirus, influenza B virus, and human immunodeficiency virus. Influenza A was one of the most common co-infective viruses, which may have caused initial false-negative results of real-time reverse-transcriptase polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Laboratory and imaging findings alone cannot help distinguish co-infection from SARS-CoV-2 infection. Newly developed syndromic multiplex panels that incorporate SARS-CoV-2 may facilitate the early detection of co-infection among COVID-19 patients. By contrast, clinicians cannot rule out SARS-CoV-2 infection by ruling in other respiratory pathogens through old syndromic multiplex panels at this stage of the COVID-19 pandemic. Therefore, clinicians must have a high index of suspicion for coinfection among COVID-19 patients. Clinicians can neither rule out other co-infections caused by respiratory pathogens by diagnosing SARS-CoV-2 infection nor rule out COVID-19 by detection of non-SARS-CoV-2 respiratory pathogens. After recognizing the possible pathogens causing co-infection among COVID-19 patients, appropriate antimicrobial agents can be recommended.

Indexed as

Anti-Infective AgentsBetacoronavirusClinical Laboratory TechniquesCoinfectionCoronavirus InfectionsCOVID-19COVID-19 TestingCOVID-19 VaccinesDrug Therapy, CombinationHumansPandemicsPneumonia, ViralPractice Guidelines as TopicReagent Kits, DiagnosticSARS-CoV-2Anti-Infective AgentsCovid-19 aAPC vaccineCOVID-19 VaccinesReagent Kits, DiagnosticCo-infectionCOVID-19Influenza virusesSARS-CoV-2

Identifiers

PMID32482366
PMCPMC7245213
OpenAlexW3026446975

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.