COVID and bacterial pneumonia

Q: Hospitalized patients with COVID-19 are highly prone to develop secondary bacterial pneumonia?

A) True

B) False

Answer: B

Contrary to popular belief, patients with known COVID-19 are not very prone to develop secondary bacterial pneumonia. There is no need to start empiric antibiotics. Only 1 in 5 patients develop superimposed bacterial pneumonia in selected patients.

In patients with uncertain COVID-19 infection, it may be prudent to start empiric antibiotics but should be quickly curtailed at the confirmation of the diagnosis unless doubts persist. Although positive procalcitonin is well-known in COVID patients, it carries a good value if it turns out to be low or negative.

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References:

1. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020; 323:1061.

2. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395:1054.