Post-acute COVID-19 associated with evidence of bystander T-cell activation and a recurring antibiotic-resistant bacterial pneumonia

Elife. 2020 Dec 17:9:e63430. doi: 10.7554/eLife.63430.

Abstract

Here, we describe the case of a COVID-19 patient who developed recurring ventilator-associated pneumonia caused by Pseudomonas aeruginosa that acquired increasing levels of antimicrobial resistance (AMR) in response to treatment. Metagenomic analysis revealed the AMR genotype, while immunological analysis revealed massive and escalating levels of T-cell activation. These were both SARS-CoV-2 and P. aeruginosa specific, and bystander activated, which may have contributed to this patient's persistent symptoms and radiological changes.

Keywords: Pseudomonas aeruginosa; SARS-CoV-2; human; infectious disease; metagenomics; microbiology; t-cells activation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • COVID-19 / complications*
  • COVID-19 / immunology
  • COVID-19 / therapy
  • Drug Resistance, Multiple, Bacterial
  • Humans
  • Lung / microbiology
  • Lymphocyte Activation*
  • Male
  • Meropenem / pharmacology
  • Meropenem / therapeutic use
  • Metagenomics
  • Middle Aged
  • Piperacillin, Tazobactam Drug Combination / pharmacology
  • Piperacillin, Tazobactam Drug Combination / therapeutic use
  • Pneumonia, Ventilator-Associated / diagnostic imaging
  • Pneumonia, Ventilator-Associated / drug therapy*
  • Pneumonia, Ventilator-Associated / etiology
  • Pseudomonas Infections / diagnostic imaging
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / etiology
  • Pseudomonas aeruginosa / isolation & purification
  • Recurrence
  • Respiration, Artificial
  • SARS-CoV-2*
  • T-Lymphocytes / immunology*

Substances

  • Anti-Bacterial Agents
  • Piperacillin, Tazobactam Drug Combination
  • Meropenem