Shu Wenxiu, Yang Qianqian, Le Jing, Cai Qianqian, Dai Hui, Luo Liufei, Tong Jiaqi, Song Yanping, Chen Bingrong, Tang Yaodong, Jin Dian
Department of Hematology, Ningbo Medical Center Lihuili Hospital, Ningbo, 315000, China.
Department of Respiratory Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo, 315000, China.
Eur J Med Res. 2024 Dec 3;29(1):576. doi: 10.1186/s40001-024-02180-0.
Coinfections in patients with coronavirus disease 2019 (COVID-19) affect patient prognosis. Patients with hematologic malignancies (HMs) are usually immunosuppressed and may be at high risk of coinfection, but few related data have been reported. Here, we conducted a retrospective study to explore coinfections in patients with HMs and COVID-19 by next-generation sequencing (NGS) of bronchoalveolar lavage fluid (BALF).
The data of hospitalized patients with pneumonia who underwent NGS analysis of BALF were reviewed. COVID-19 patients with HMs were enrolled in the HM group, and those without HMs were enrolled in the non-HM group. The coinfections of the two groups identified by NGS were analyzed.
Fifteen patients were enrolled in the HM group, and 14 patients were enrolled in the non-HM group. The coinfection rates in the HM group and non-HM group were 80.0% and 85.7%, respectively. The percentage of coinfected bacteria in the HM group was significantly lower than that in the non-HM group (20.0% vs 71.4%, p = 0.005). The coinfection rates of fungi and viruses were 60.0% and 35.7%, respectively, in the HM group and 35.7% and 78.6%, respectively, in the non-HM group, with no significant differences. The most common coexisting pathogen in patients with HMs was Pneumocystis jirovecii (33.3%), and the most common coexisting pathogen in patients without HMs was human gammaherpesvirus 4 (50%). Coinfection with herpesviruses occurred frequently in both groups.
Our study showed that the majority of hospitalized patients with COVID-19 are likely to be co-infected with other pathogens. Pneumocystis jiroveci and herpesvirus are commonly coinfected pathogens in patients with HMs. Bacterial coinfection is rare in patients with HMs but is more common in patients without HMs.
2019冠状病毒病（COVID-19）患者的合并感染会影响患者预后。血液系统恶性肿瘤（HM）患者通常免疫功能低下，可能有较高的合并感染风险，但相关数据报道较少。在此，我们通过支气管肺泡灌洗液（BALF）的二代测序（NGS）进行了一项回顾性研究，以探讨HM合并COVID-19患者的合并感染情况。
回顾了接受BALF NGS分析的住院肺炎患者的数据。患有HM的COVID-19患者被纳入HM组，未患HM的患者被纳入非HM组。分析了两组通过NGS鉴定的合并感染情况。
HM组纳入15例患者，非HM组纳入14例患者。HM组和非HM组的合并感染率分别为80.0%和85.7%。HM组合并感染细菌的比例显著低于非HM组（20.0%对71.4%，p = 0.005）。HM组真菌和病毒的合并感染率分别为60.0%和35.7%，非HM组分别为35.7%和78.6%，无显著差异。HM患者中最常见的共存病原体是耶氏肺孢子菌（33.3%），非HM患者中最常见的共存病原体是人类γ疱疹病毒4（50%）。两组中疱疹病毒合并感染均较为常见。
我们的研究表明，大多数住院COVID-19患者可能合并感染其他病原体。耶氏肺孢子菌和疱疹病毒是HM患者常见的合并感染病原体。HM患者细菌合并感染少见，但在非HM患者中更常见。
