Journal Article

Influenza co-infection associated with severity and mortality in COVID-19 patients

Alosaimi, Bandar, Alkadi, Haitham S., Zafar, Adnan, Al Rehily, Sanaa Saad, Naeem, Asif, Hamed, Maaweya E., Almutairi, Abdullah Z., Alanazi, Thamer

2021

Overview

Background In COVID-19 patients, undetected co-infections may have severe clinical implications associated with increased hospitalization, varied treatment approaches and mortality. Therefore, we investigated the implications of viral and bacterial co-infection in COVID-19 clinical outcomes. Methods Nasopharyngeal samples were obtained from 48 COVID-19 patients (29% ICU and 71% non-ICU) and screened for the presence of 24 respiratory pathogens using six multiplex PCR panels. Results We found evidence of co-infection in 34 COVID-19 patients (71%). Influenza A H1N1 (n = 17), Chlamydia pneumoniae (n = 13) and human adenovirus (n = 10) were the most commonly detected pathogens. Viral co-infection was associated with increased ICU admission (r = 0.1) and higher mortality (OR 1.78, CI = 0.38–8.28) compared to bacterial co-infections (OR 0.44, CI = 0.08–2.45). Two thirds of COVID-19 critically ill patients who died, had a co-infection; and Influenza A H1N1 was the only pathogen for which a direct relationship with mortality was seen (r = 0.2). Conclusions Our study highlights the importance of screening for co-infecting viruses in COVID-19 patients, that could be the leading cause of disease severity and death. Given the high prevalence of Influenza co-infection in our study, increased coverage of flu vaccination is encouraged to mitigate the transmission of influenza virus during the on-going COVID-19 pandemic and reduce the risk of severe outcome and mortality.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Analysis / Bacterial infections / Biomedical and Life Sciences / Biomedicine / Chlamydophila pneumoniae / Clinical Virology / Co-infection / Comorbidity / Coronaviruses / Coronaviruses: emerging and re-emerging pathogens in humans and animals / COVID-19 / COVID-19 infection / death / disease severity / Influenza / Influenza A / Influenza A H1N1 / Influenza A virus / Mastadenovirus / Middle East respiratory syndrome / mixed infection / Mortality / Pandemics / Pathogens / Patients / polymerase chain reaction / Respiratory diseases / risk reduction / SARS-CoV-2 / Vaccination / Virology / Viruses