So far more than 473,000 people have been killed by COVID-19, but health care professionals are learning more about how the disease can lead to death.
Superinfections — a common complication in which a secondary bacterial infection occurs on top of the primary viral infection — are also to blame.
Early evidence Trusted Source suggests that about 50 percent of people who’ve died from COVID-19 also had a secondary bacterial or fungal infection, some of which were resistant to antibiotics.
Medical experts aren’t surprised that patients with COVID-19 are battling superinfections in the hospital.
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Superinfections frequently coincide with other viral infections like the flu. In fact, high death rates observed during past flu pandemicsTrusted Source, including the 1918 flu pandemic, have mainly been caused by secondary bacterial infections, many of which are caused by drug-resistant bacteria.
“What’s going on here is that half of COVID patients are getting untreatable antimicrobial-resistant infections, so our antibiotics, our antifungals just don’t work,” said Corrie Detweiler, PhD, a microbiologist at the University of Colorado, Boulder studying drug resistance in bacteria and possible treatments.
“The superinfection problem isn’t new at all,” added Detweiler. “It’s just that COVID is highlighting it.”
Why patients with COVID-19 are getting superinfections
People who have prolonged stays in the intensive care unit (ICU), like those with COVID-19 who can be hospitalized for weeks, are prone to secondary infections.
Dr. Matthew Grant, a Yale Medicine infectious disease specialist, says this is due to a couple of reasons.
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First is a condition called ventilator-associated pneumoniaTrusted Source, a lung infection that develops when harmful germs get into a person’s lungs via the part of the ventilator that goes through the throat.
“This is not unique to people with COVID in the sense that people who have other respiratory viral illnesses of (this part of the) respiratory tract are also prone to bacterial pneumonia as a superinfection,” Grant said.
Patients with COVID-19 are also vulnerable to a number of other infections, like a urinary tract infection or bloodstream infection, since they’re often hooked up to IVs and catheters that can bring outside bacteria into the body.
“Basically, being on a ventilator, being sedated so you’re not moving around much, having all these tubes going into places they’re not normally going into, you’re at dramatically higher rates of day-to-day risk (for infections),” Grant said.
Some health experts suspect that certain treatments used on patients with COVID-19 could increase their risk of getting a secondary infection, Grant says.
For example, steroids, which have been used on people with severe cases of COVID-19, have a known risk of bacterial infection, says Grant.
Another immunosuppressant drug called tocilizumab, which is being used on patients with COVID-19, is also linked to an increased risk for bacterial infections, according to Grant.
Hospitalized patients with severe cases of COVID-19 experience massive lung damage, making them more susceptible to harm from dangerous pathogens.
When a healthy person breathes in a pathogen — which happens all the time — their immune system kicks in and kills them right away, according to Detweiler.
“If you’re really sick, then your immune system isn’t that well able to kill these opportunistic pathogens that are everywhere — they’re in your house, they’re on the playground, they’re in hospitals,” Detweiler said.
The immune systems of the sickest patients with COVID-19 produce a cytokine storm — a condition in which the immune system overreacts and causes widespread inflammation in the body.