ABSTRACT
The pathophysiology of COVID-19 is not fully known. Respiratory infection caused by more than one viral pathogen (viral co-infection) or both viral and bacterial pathogens (combined viral and bacterial pneumonia) have been described. Secondary bacterial pneumonia can follow the initial phase of viral respiratory infection or occur during the recovery phase. No obvious pattern or guidelines exist for viral coinfection, combined viral and bacterial pneumonia, or secondary bacterial pneumonia in the context of SARS-CoV-2. Based on existing clinical data and experience with similar viruses such as influenza and SARS-CoV, the management approach in the context of COVID-19 should, ideally, take into consideration the overall presentation as well as the trajectory of illness.
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