Low rate of bacterial co-infection in patients with COVID-19

We agree with Michael J Cox and colleagues1 that clinical management of COVID-19 would be enhanced by further characterisation of bacterial co-infections. A few case reports have described examples of such co-infections.2,3,4 However, national5 and international6 guidelines recommend empirical antibiotics for all patients who are severely ill with suspected COVID-19, and that cessation of therapy is left to the clinicians' discretion. Pending the widespread availability of metagenomic sequencing as envisaged by Cox and colleagues,1 we argue that traditional diagnostics still have a role.