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. 2020 Dec 30;14(3):389–416. doi: 10.1016/j.jiph.2020.12.025

Table 4.

A Summary of Secondary Bacterial Infection mechanisms, responsible for respiratory viral infections and bacterial confections.

Mechanism Description Refs
-Virus causing increase in Bacterial attachment -Receptors are modulated by viruses, hence increasing attachment of bacteria. [158,168]
-Cells are destroyed by enzymes from Viruses. -Glycoproteins are destroyed by enzymes, especially those that are involved in inhibition of bacterial adhesion. [158]
-Muco-ciliary clearance is reduced. -Decreased muco-ciliary clearance due to virus causes reduced bacterial material production. [158]
-Reduced Chemotaxis -Chemotactic factor is reduced by virus hence and decreasing response to invading organisms. [158]
-Straight consequence on phagocytic, initiation of functions of alveolar macrophages after phagocytic -Many functions like fusion of phagosome and lysosome is stopped by virus. [158]
-Undeveloped phagocytes are induced. -Macrophages are disrupted by viruses and are replaced with undeveloped phagocytes [158,169,170]
-Decrease in surfactant amount -Alveolar type 2 pneumocytes’ function is impaired by viruses. [158,171,172]
-Dysbiosis is introduced in microbiome of lower respiratory-tract. -Immune-response towards respiratory viral-infections is affected by dysbiosis in microbiome. [173]
-Innate and adaptive immunity is dysregulated. -During the development of apoptosis alverolar macrophages are decreased in number by virus. [[174], [175], [176], [177]]
-Inflammation and apoptosis are modulated. -Post viral infection secondary-bacterial pneumonia is facilitated by apoptosis and autophagy. [178]
-Immune function of antibacterial is reduced at respiratory-epithelium. -Viral infections of respiratory-tract causes inclination to secondary bacterial-infection by deviating immune status of respiratory tract. [158,179,180]
-Nutritional immunity is disturbed. -Some viral infections destabilize nutritional shield and enhance bacterial invasion. [[181], [182], [183]]
-Suppression of immune system -Some viruses like HIV induce immunosuppression. [[184], [185], [186]]
-Synergistic viral and bacterial co infections -Co infection’s immuno-pathogenicity is regulated by bacteria as well as viruses. [159,171,187]
-Planktonic bacteria released from biofilms -Biofilm structure is disrupted by manipulation of many factors like H2O2 and chemokines due to viruses. [177,[188], [189], [190]]