Scientists studying bacteriophages and their potential therapeutic applications are discussing whether bacterial viruses could somehow help in the global situation caused by the spread of COVID-19, the disease caused by the new coronavirus SARS-CoV-2.

The first thing that comes to mind is the use of phage therapy for bacterial infections that can complicate COVID-19. Dangerous bacterial complications are known to cause death in patients with influenza. It's quite possible that this situation is also characteristic of COVID-19.

This week, Dr. Julie Gerberding, former director of the US Centers for Disease Control (CDC) and now a researcher at the pharmaceutical company Merck, wrote an article on the issue of secondary multidrug-resistant bacterial infections in the context of COVID-19 . She emphasizes that complications caused by antibiotic-resistant bacteria are likely to occur in COVID-19 patients, and that patients at increased risk of multidrug-resistant infections are the same group of patients at highest risk of severe COVID-19.

Julia Gerberding points to studies of influenza epidemics, which show that during the 2009 H1N1 influenza pandemic, bacterial pneumonia was observed in 29-55% of deceased patients, and during the 1918 influenza pandemic, the majority of fatalities also appeared to be caused by bacterial pneumonia. Furthermore, the author points to a recent report published in the journal The Lancet, which concerns COVID-19 patients from two Chinese hospitals: among patients hospitalized for COVID-19, approximately one-seventh had secondary infections, and about half of them died. The study also notes that 100% of patients who died from COVID-19 had sepsis, although it was not determined whether it was viral or bacterial in origin.

So, we have questions that require clarification and discussion:

How often do COVID-19 patients have secondary bacterial infections?

How often is sepsis in COVID-19 patients bacterial in origin?

How often are bacterial strains that infect COVID-19 patients resistant to antibiotics?

- What types of bacteria pose the biggest challenge for patients with bacterial complications of COVID-19? ( For influenza, these include Streptococcus pneumoniae, Haemophilus influenzae , and Staphylococcus aureus .)

- Can bacteriophages help such patients?

If bacteriophages can help, will doctors, who are extremely busy due to the huge number of COVID-19 patients, have the time and opportunity to use phage therapy experimentally?

Will regulatory authorities be able to review applications for all experimental uses of phage therapy during the pandemic?

- Will there be research laboratories and/or biotech companies that can create phage preparations to treat specific COVID-19 patients?

Looking to the future

Even if not now, when the situation is poorly controlled, but in the future, when COVID-19 patients will still be present but doctors will have more time to treat them, phage therapy may be appropriate for some of these patients. Therefore, it's worth discussing this now: the possibility of helping COVID-19 patients, how to obtain patient samples, how to create phage libraries to combat the relevant pathogens, and how to coordinate care.

You can join the discussion here: phage.directory/slack

Update on identified antibiotic-resistant bacterial strains causing secondary infections in COVID-19 patients: https://www.notion.so/COVID-AMR-Secondary-Infections-45ca8c5d0cda4fad89e441fdc1013f0e