Volume 27, Number 3—March 2021
Dispatch
Lung Pathology of Mutually Exclusive Co-infection with SARS-CoV-2 and Streptococcus pneumoniae
Table
Quantification of SARS-CoV-2 RNA and Streptococcus pneumoniae DNA in 42 lung sections from a patient in Japan co-infected with both pathogens*
Lung lobe | Lung section | SARS-CoV-2 RNA, copies/μL | GAPDH mRNA, copies/μL | SARS-CoV-2 RNA/GAPDH mRNA ratio | SARS-CoV-2 RNA score† | S. pneumoniae DNA, copies/μL | ACTB DNA, copies/μL | S. pneumoniae DNA/ACTB DNA ratio × 105 | S. pneumoniae DNA score‡ |
---|---|---|---|---|---|---|---|---|---|
RUL |
R1§ | 2.01 × 106 | 1.31 × 103 | 1,534 | 3 | 1.67 × 102 | 5.66 × 104 | 295 | 2 |
R2 | 1.71 × 106 | 1.03 × 103 | 1,660 | 3 | 2.01 × 102 | 8.24 × 104 | 244 | 2 | |
R3 | 6.66 × 105 | 1.66 × 103 | 401 | 2 | 4.17 × 101 | 3.40 × 104 | 123 | 2 | |
R4 | 6.93 × 105 | 1.70 × 103 | 408 | 2 | 5.36 × 101 | 4.58 × 104 | 117 | 2 | |
R5 | 6.87 × 105 | 1.80 × 103 | 382 | 2 | 2.48 × 101 | 7.39 × 104 | 34 | 1 | |
R6 | 1.98 × 105 | 1.21 × 103 | 164 | 2 | 9.07 × 101 | 1.33 × 105 | 68 | 1 | |
R7 | 8.98 × 105 | 1.65 × 103 | 544 | 2 | 5.24 × 101 | 1.02 × 105 | 51 | 1 | |
R8 |
5.48 × 105 |
8.66 × 102 |
633 |
2 |
UDL |
1.07 × 105 |
UDL |
0 |
|
RLL |
R9 | 7.50 × 105 | 8.82 × 102 | 850 | 2 | 2.10 × 102 | 7.33 × 104 | 286 | 2 |
R10 | 1.71 × 106 | 1.31 × 103 | 1,305 | 3 | 4.50 × 102 | 1.02 × 105 | 441 | 2 | |
R11 | 1.15 × 106 | 1.08 × 103 | 1,065 | 3 | 8.94 × 102 | 6.72 × 104 | 1,330 | 3 | |
R12 | 1.39 × 105 | 8.85 × 102 | 157 | 2 | 4.70 × 103 | 6.33 × 104 | 7,425 | 3 | |
R13 | 3.45 × 105 | 9.42 × 102 | 366 | 2 | 9.44 × 101 | 8.59 × 104 | 110 | 2 | |
R14 | 6.62 × 103 | 5.55 × 102 | 12 | 1 | 5.37 × 103 | 6.98 × 104 | 7,693 | 3 | |
R15 | 1.85 × 104 | 9.14 × 102 | 20 | 1 | 1.74 × 103 | 9.09 × 104 | 1,914 | 3 | |
R16 | 1.40 × 104 | 8.20 × 102 | 17 | 1 | 4.14 × 103 | 1.03 × 105 | 4,019 | 3 | |
R17 | 2.92 × 104 | 8.58 × 102 | 34 | 1 | 2.67 × 103 | 6.54 × 104 | 4,083 | 3 | |
R18 | 1.93 × 104 | 8.04 × 102 | 24 | 1 | 3.18 × 103 | 8.22 × 104 | 3,869 | 3 | |
R19 | 3.05 × 104 | 6.46 × 102 | 47 | 1 | 2.56 × 103 | 6.00 × 104 | 4,267 | 3 | |
R20 | 5.16 × 104 | 6.81 × 102 | 76 | 1 | 2.92 × 103 | 5.92 × 104 | 4,932 | 3 | |
R21 | 1.50 × 104 | 5.82 × 102 | 26 | 1 | 3.18 × 103 | 8.53 × 104 | 3,728 | 3 | |
R22 |
5.27 × 105 |
5.88 × 102 |
896 |
2 |
2.12 × 101 |
4.57 × 104 |
46 |
1 |
|
LUL |
L1 | 5.44 × 106 | 1.52 × 103 | 3,579 | 3 | UDL | 7.39 × 104 | UDL | 0 |
L2 | 1.34 × 106 | 1.91 × 103 | 702 | 2 | 6.85 × 101 | 1.20 × 105 | 57 | 1 | |
L3 | 6.73 × 105 | 1.78 × 103 | 378 | 2 | UDL | 6.16 × 104 | UDL | 0 | |
L4 | 1.52 × 105 | 1.36 × 103 | 112 | 2 | 2.00 × 101 | 8.92 × 104 | 22 | 1 | |
L5 | 9.59 × 105 | 1.83 × 103 | 524 | 2 | UDL | 4.99 × 104 | UDL | 0 | |
L6 | 1.59 × 105 | 1.33 × 103 | 120 | 2 | 3.13 × 102 | 4.26 × 104 | 735 | 2 | |
L7 | 3.85 × 106 | 1.94 × 103 | 1,985 | 3 | 1.50 × 101 | 6.69 × 104 | 22 | 1 | |
L8 | 1.77 × 106 | 2.36 × 103 | 750 | 2 | UDL | 5.40 × 104 | UDL | 0 | |
L9 | 1.02 × 106 | 1.37 × 103 | 745 | 2 | UDL | 4.96 × 104 | UDL | 0 | |
L10 |
3.11 × 106 |
2.22 × 103 |
1,401 |
3 |
UDL |
6.25 × 104 |
UDL |
0 |
|
LLL | L11 | 1.27 × 105 | 1.07 × 103 | 119 | 2 | 5.54 × 102 | 4.49 × 104 | 1,234 | 3 |
L12 | 3.80 × 104 | 8.48 × 102 | 45 | 1 | 6.42 × 103 | 1.12 × 105 | 5,732 | 3 | |
L13 | 2.16 × 104 | 7.91 × 102 | 27 | 1 | 5.91 × 103 | 8.87 × 104 | 6,663 | 3 | |
L14 | 4.87 × 104 | 8.73 × 102 | 56 | 1 | 2.85 × 103 | 7.76 × 104 | 3,673 | 3 | |
L15 | 4.65 × 104 | 1.22 × 103 | 38 | 1 | 4.08 × 103 | 6.36 × 104 | 6,415 | 3 | |
L16 | 2.86 × 104 | 8.88 × 102 | 32 | 1 | 5.68 × 103 | 6.80 × 104 | 8,353 | 3 | |
L17 | 3.42 × 104 | 9.42 × 102 | 36 | 1 | 3.58 × 103 | 6.45 × 104 | 5,550 | 3 | |
L18 | 3.89 × 104 | 9.47 × 102 | 41 | 1 | 4.64 × 103 | 6.87 × 104 | 6,754 | 3 | |
L19 | 4.25 × 103 | 5.81 × 102 | 7 | 1 | 5.82 × 102 | 1.02 × 105 | 571 | 2 | |
L20 | 1.56 × 104 | 8.09 × 102 | 19 | 1 | 6.10 × 101 | 9.11 × 104 | 67 | 1 |
*ACTB, β-actin; GAPDH, glyceraldehyde 3-phosphate dehydrogenase; LLL, left lower lobe; LUL, left upper lobe; RLL, right lower lobe; RUL, right upper lobe; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; UDL, under detection limit. †SARS-CoV-2-RNA score is as follows: score 1, SARS-CoV-2 RNA/GAPDH mRNA ratio<100; score 2, 100–1,000; score 3, 1,000–10,000. ‡S. pneumoniae DNA score is as follows: score 1, S. pneumoniae DNA/ ACTB DNA ratio × 105 <100; score 2, 100–1,000; score 3, 1,000–10,000. §Lung sections R1–R22 and L1–L20) are shown in Figure 1.
1These authors contributed equally to this article.