Bacterial and Viral Coinfection Among Patients With COVID-19: A Case Report Study

Background: Various studies suggest that coinfection with two or more respiratory pathogens is common. Coinfection with two viruses affects the host, exerts a synergic effect, and can influence the disease pathogenesis, immune system responses, treatment, and outcomes. Influenza and COVID-19 respiratory viruses have highly similar symptoms and bring about problems, including delayed treatment and proper diagnosis. This report describes three cases of coinfection with COVID-19, influenza, and tuberculosis (TB). Case Presentation: The first case is a 46-year-old Iranian housewife with a history of chronic coughs from the past two months who presented with the exacerbation of coughs together with dyspnea. The second case is a 62-year-old Iranian housewife with a history of type 2 diabetes mellitus who presented with productive coughs, dyspnea, and weakness. The third case is an Iranian pregnant housewife who presented with myalgia, fever, chills, and dry coughs from the previous week. All three cases tested positive for influenza and COVID-19 polymerase chain reaction tests and were treated accordingly. In subsequent visits, their condition was reported to be improving. Conclusion: Coinfection with two viruses can result in the synergism of pathogens. Moreover, coinfection with a bacterial pathogen can cause further problems. In these cases, coinfection with two viruses and mycobacterial infection in one of the cases, along with comorbidities and pregnancy, implied that these conditions entail immediate diagnosis and appropriate treatment choices.