The COVID-19 pandemic is associated with significant morbidity as well as social and economic cost. Current knowledge on the various aspects of the disease, including pathogen biology, clinical presentation in different populations, and case management are not well understood. The symptoms of COVID-19 infection appear after an incubation period of between 2-14 days. There is limited evidence on the interaction between COVID-19 and other microbial infections. However, secondary bacterial infections are recognized as significant in the outcome of SARS-CoV-2 infection. It might be anticipated therefore that microbial population of the respiratory tract may influence the occurrence and severity of COVID-19 and this needs to be investigated. The thinking that frequent exposure of the African population to other infections and BCG offers a level of protection against COVID-19 is intriguing and needs further explanation for understanding of pathogenesis and host immunity.

The aim of this study is to contribute to understanding of multimorbidity and disease epidemiology through surveillance and monitoring of appropriate case management within the COVID-19 pandemic in Ghana. The findings have been shared with relevant stakeholders to support antimicrobial stewardship programs at the hospitals.