On the 7th of January 2020 was identified a novel coronavirus originally abbreviated 2019-Ncov by WHO and later renamed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the Coronavirus study Group. On January 30th, WHO declares the SARS-CoV-2 outbreak as a Public Health Emergency of international concern. Globally, as 6 September 2021, there have been 220.563.227 confirmed cases of COVID-19, including 4.565.483 deaths, reported to WHO. This illness later named COVID-19 (acronym for coronavirus disease 2019 ) encompasses a wide spectrum of clinical manifestations that can be respiratory or extra-respiratory ones (anosmia, conjunctivitis, acute cerebrovascular disease, conscious disturbance, and skeletal muscle injury, generalized macular or maculopapular exanthema, diarrhea, nausea, vomiting, abdominal pain), with different degrees of severity and with the possibility to develop several complications (ARDS, coagulation dysfunction, renal and cardiovascular complications) that can lead patients to death. What emerged since the early phase of the pandemic in 2019, was the high antibiotic prescription rate in patients with severe covid-19 fearing bacterial and fungal co-infections, even without a clear demonstrations of an overlapping secondary infection. The aim of our study was to report data about bacterial, fungal coinfections systematically collected searching Medline, for eligible studies published from January 2020 to September 2021. We included patients of all ages, in all settings. The main outcomes were the proportion of patients with a bacterial, fungal co-infection. Table 1 shows many studies reporting community-acquired bacterial coinfections, while Table 2 illustrates main studies about nosocomial coinfections in patients hospitalized with covid-19. The results of our studies underlines the need to include antimicrobial stewardship programs in the management of covid-19 patients considering the low reported prevalence/incidence of bacterial-fungal coinfections.
From out research prevalence and incidence of community acquired bacterial and fungal coinfections ranged from 0% to 19,8%and from 0% to 48% for nosocomial coinfections.