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Infectious Diseases

Rates of Co-infection Between SARS-CoV-2 and Other Respiratory Pathogens

Educational Objective
To understand the relationship between SARS-CoV-2 and other respiratory pathogens

1 Credit CME

JAMA

Published Online: April 15, 2020

Research Letter

Article Information and Disclosures

David Kim, MD, PhD¹;

James Quinn, MD, MS¹;

Benjamin Pinsky, MD, PhD²;

Nigam H. Shah, MBBS, PhD³;

Ian Brown, MD, MS¹

Author Affiliations

¹Department of Emergency Medicine, Stanford University School of Medicine, Stanford, California
²Department of Pathology and Medicine, Stanford University School of Medicine, Stanford, California
³Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, California

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As of April 3, 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had caused 972 303 cases of coronavirus disease 2019 (COVID-19) and 50 322 deaths worldwide.¹ Early reports from China suggested that co-infection with other respiratory pathogens was rare.² If this were the case, patients positive for other pathogens might be assumed unlikely to have SARS-CoV-2. The Centers for Disease Control and Prevention endorsed testing for other respiratory pathogens, suggesting that evidence of another infection could aid the evaluation of patients with potential COVID-19 in the absence of widely available rapid testing for SARS-CoV-2.³ Here we report on co-infection rates between SARS-CoV-2 and other respiratory pathogens in Northern California.

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Article Information

Published Online: April 15, 2020. doi:10.1001/jama.2020.6266

Correction: This Research Letter was corrected on May 1, 2020, for incorrect age and sex data in Table 1.

Corresponding Author: James Quinn, MD, MS, Department of Emergency Medicine, Stanford University School of Medicine, 300 Pasteur Dr, Alway Bldg M023, Stanford, CA 94305 (quinnj@stanford.edu).

Author Contributions: Drs Kim and Brown had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Kim, Quinn, Brown.

Acquisition, analysis, or interpretation of data: Kim, Quinn, Pinsky, Shah, Brown.

Drafting of the manuscript: Kim, Quinn.

Critical revision of the manuscript for important intellectual content: Kim, Quinn, Pinsky, Shah, Brown.

Statistical analysis: Kim, Shah.

Administrative, technical, or material support: Quinn, Pinsky, Brown.

Supervision: Quinn, Brown.

Conflict of Interest Disclosures: None reported.

References

Coronavirus Disease 2019 (COVID-19) Situation Report–74. World Health Organization. Published April 3, 2020. Accessed April 5, 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200403-sitrep-74-covid-19-mp.pdf

Chen N , Zhou M , Dong X , et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513. doi:10.1016/S0140-6736(20)30211-7 PubMed Google Scholar Crossref

Evaluating and Testing Persons for Coronavirus Disease. 2019 (COVID-19). Centers for Disease Control and Prevention. Published March 14, 2020. Accessed March 20, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.