Mycoplasma pneumoniae, COVID-19 comorbidity: increased thrombosis risk

  • Zha L & al.
  • J Infect
  • 8 Jul 2020

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • COVID-19 with Mycoplasma pneumoniae coinfection appears to be associated with increased thrombosis risk.
  • Coinfection was not associated with an increase in major complaints at admission.

Why this matters

  • Close monitoring, routine anticoagulation prophylactics are indicated.

Key results

  • Of 874 patients, 2.5% had coinfection.
    • Among 88 COVID-19-only patients in matched comparator group, median age was 57 years.
    • Among the 22 with coinfection, median age was 56.5 years.
  • Major complaints at admission, overall: fever (59.1%), cough (28.2%), dyspnea (8.2%), fatigue (9.1%), diarrhea (3.6%).
  • Rheumatoid arthritis was present only in the coinfection group (9.1% vs 0.0% in COVID-only group; P=.05).
  • Vs patients with COVID-19 only, patients with coinfection had, on average (±standard deviation):
    • Higher bilirubin levels: 14.67±28.72 vs 8.03±4.07 (P=.037).
    • Shorter prothrombin time: 11.60±0.84 vs 13.34±5.4 (P=.004).
    • Higher prothrombin activity: 104.90±20.14 vs 89.78±30.65 (P=.006).
  • Different antibiotic, corticosteroid strategies had no effect on outcomes.
  • Mortality: 1 patient with coinfection (4.5%) vs 2 (2.3%) with COVID-19 only (P=1.00).
  • Patients with coinfection also had longer cough duration: 20 vs 16.25 days (P=.043). 

Study design

  • Retrospective, observational analysis of morbidity, other clinical outcomes of Chinese patients.
  • Funding: Anhui Provincial Special Project.

Limitations

  • Retrospective, observational.
  • Small sample.
  • Possible false negatives.
  • Selection bias.