SARS-CoV-2 Co-infections with Bacteria and Fungi in Symptomatic and Asymptomatic COVID-19 Patients in Rivers State, Nigeria

BACKGROUND: Ever since the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2) which caused COVID-19 disease began to spread, the globe has been dealing with an unparalleled public health calamity. The entire health system is under strain as a result of the pandemic. Above all, microbiologists have experienced significant challenges in terms of diagnosis. The intriguing part that was long overlooked at this time was the contribution of bacterial and fungal infections to the severity of COVID-19 infection. Patients with SARS-CoV-2 infection are more predisposed to co-infections with bacteria and fungi as a result of immune system impairment, airway epithelium degradation, reduced mucociliary clearance, and virus-induced airway damage thereby increasing mortality and morbidity. METHODS: A total of 201 COVID-19-positive nasopharyngeal oropharyngeal samples were diagnosed using a rapid diagnostic test kit and confirmed with Reverse transcriptase real-time polymerase chain reaction (RtPCR) with cycle threshold of <=25 from three COVID-19 accredited laboratories in Rivers State was plated out on different culture media and isolates were identified using standard methods. RESULTS: Seventy-two (36.0%) of the SARS-CoV-2 patients overall exhibited pooled proportions of laboratory-confirmed bacterial and fungal infections. Among the three-study areas, Rivers State University Teaching Hospital (RSUTH) has the highest number of isolates (51.4%) followed by the University of Port Harcourt Teaching Hospital (UPTH) (37.5%) and then the University of Port Harcourt (UPH) (11.10%). Bacteria had a total number of 35.3% and fungi 0.5%. Bacterial isolates identified were _Staphylococcus aureus_ (65.3%), _Klebsiella spp _(22.2%), _Pseudomonas aeruginosa _(11.1%) and fungi isolate _Candia albicans_ (1.4%). _Staphylococcus aureus_ was the most common bacteria co-infection pathogens isolated. Men and single individuals had the highest prevalence while those between the age group of 41-50 also showed the highest occurrence of bacterial and fungi isolates_. _This study has further confirmed the high coinfection rates of SARS-CoV-2, bacterial and fungi in Rivers State, Nigeria.