COVID-19 and 'Pasteurella multocida' pulmonary coinfection: A case series

Objectives: In COVID-19 patients, bacterial and fungal pulmonary coinfections, such as Streptococcus pneumoniae, 'Staphylococcus aureus', 'Haemophilus influenzae', or 'Aspergillus', have been reported, but to our knowledge, no case has been reported due to 'Pasteurella multocida'. Patients and methods: We describe three cases of 'Pasteurella multocida' coinfections occurring during the 4th wave of COVID-19 in Martinique (French West Indies). Results: All three cases were fatal; thus, 'Pasteurella multocida' has to be considered as a potentially severe coinfection agent. Conclusions: Alteration of the epithelial-endothelial barrier due to a SARS-CoV-2 infection probably promotes the expression of a 'Pasteurella' infection. In addition, the SARS-CoV-2 infection induced immunosuppression, and an inflammatory cascade could explain the infection's severity. The use of corticosteroids, which are part of the first-line therapeutic arsenal against COVID-19, may also promote the pathogenicity of this agent.