Can bacteriophages help patients with coronavirus infections?

Scientists involved in the study of bacteriophages and their potential for therapeutic applications are considering whether bacterial viruses can somehow help due to the global spread of COVID-19—a disease caused by the novel coronavirus SARS-CoV-2.

The first thing that comes to mind is the use of phage therapy for bacterial infections that can complicate a COVID-19 infection. It is known that dangerous bacterial complications cause the death of influenza patients. It is entirely possible that this situation is also characteristic of COVID-19.

This week, Dr. Julie Gerberding, former director of the U.S. Centers for Disease Control and Prevention (CDC), who currently works at Merck Pharmaceutical Company, wrote an article about the problem of secondary multi-drug resistant bacterial infections associated with COVID-19. She emphasizes that complications caused by antibiotic-resistant microorganisms are likely to occur in patients with COVID-19 and that patients at an increased risk for multi-drug resistant infections are most at risk from COVID-19.

Julie Gerberding draws attention to studies on influenza epidemics showing that bacterial pneumonia was observed in 29–55% of patients who died during the 2009 H1N1 influenza pandemic, and that most deaths during the 1918 influenza pandemic also appear to have been caused by bacterial pneumonia. Furthermore, the author highlights a recent report published in the journal Lancet regarding COVID-19 patients from two Chinese hospitals: among patients hospitalized for COVID-19, approximately 1/7 had secondary infections, as did about half of those who died. The study also noted that 100% of patients who died from COVID-19 had sepsis, although it was not determined whether this was viral or bacterial in nature.

We therefore have questions that need to be clarified and discussed:

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

– How often is sepsis in COVID-19 patients bacterial in nature?

– How often are bacterial strains in COVID-19 patients resistant to antibiotics?

– Which types of bacteria pose the greatest problem for patients with bacterial complications from COVID-19? ( In the case of influenza, these are Streptococcus pneumoniae , Haemophilus influenzae and Staphylococcus aureus. )

– Can bacteriophages help such patients?

– If bacteriophages can help, do doctors who are very busy due to the high number of COVID-19 patients have the time and opportunity to experiment with phage therapy?

– Will regulatory authorities be able to review applications for all phage therapy studies during an epidemic?

– Will there be scientific laboratories and/or biotechnology companies capable of producing phages to treat specific patients with COVID-19?

Looking to the future

Even if not now, while the situation is poorly controlled, in the future when COVID-19 patients remain but doctors have more time for them, phage therapy may be appropriate for some of these patients. It is worth discussing this now: the possibility of helping COVID-19 patients, collecting patient samples, creating phage libraries to combat pathogens, and coordinating care.