Frontiers in Immunology (May 2022)

Time-Dependent Increase in Susceptibility and Severity of Secondary Bacterial Infections During SARS-CoV-2

  • Amanda P. Smith,
  • Evan P. Williams,
  • Taylor R. Plunkett,
  • Muneeswaran Selvaraj,
  • Lindey C. Lane,
  • Lillian Zalduondo,
  • Yi Xue,
  • Peter Vogel,
  • Rudragouda Channappanavar,
  • Rudragouda Channappanavar,
  • Rudragouda Channappanavar,
  • Colleen B. Jonsson,
  • Colleen B. Jonsson,
  • Amber M. Smith,
  • Amber M. Smith,
  • Amber M. Smith

DOI
https://doi.org/10.3389/fimmu.2022.894534
Journal volume & issue
Vol. 13

Abstract

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Secondary bacterial infections can exacerbate SARS-CoV-2 infection, but their prevalence and impact remain poorly understood. Here, we established that a mild to moderate infection with the SARS-CoV-2 USA-WA1/2020 strain increased the risk of pneumococcal (type 2 strain D39) coinfection in a time-dependent, but sex-independent, manner in the transgenic K18-hACE2 mouse model of COVID-19. Bacterial coinfection increased lethality when the bacteria was initiated at 5 or 7 d post-virus infection (pvi) but not at 3 d pvi. Bacterial outgrowth was accompanied by neutrophilia in the groups coinfected at 7 d pvi and reductions in B cells, T cells, IL-6, IL-15, IL-18, and LIF were present in groups coinfected at 5 d pvi. However, viral burden, lung pathology, cytokines, chemokines, and immune cell activation were largely unchanged after bacterial coinfection. Examining surviving animals more than a week after infection resolution suggested that immune cell activation remained high and was exacerbated in the lungs of coinfected animals compared with SARS-CoV-2 infection alone. These data suggest that SARS-CoV-2 increases susceptibility and pathogenicity to bacterial coinfection, and further studies are needed to understand and combat disease associated with bacterial pneumonia in COVID-19 patients.

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