Prevalence and impact of SARS-CoV-2 viral respiratory co-infections on disease severity in children and adults

Abstract

ABSTRACT Introduction: The burden of SARS-CoV-2 has been widely recognized. However, it is not yet fully known whether a co-infection with another viral respiratory pathogen influences disease severity, mortality and length of hospital stay. Therefore, this paper aims to gather information on the impact of SARS-Cov-2 on disease severity and mortality, while also having a co-infection in both, children and adults. Methods: We searched PubMed, Embase, Medline, PLOS Journals, Willey Online Library and bioRxiv, to retrieve all relevant English papers. Studies that assessed the co-infection between SARS-CoV-2 and another respiratory pathogen and additionally also reported on disease severity, hospitalization or mortality were included. Results: Ultimately, 22 studies have been included in this review. In total 1593 (5%) cases of co- infection have been reported among 32,383 patients. We identified ten different respiratory pathogens that caused co-infection. The mortality rate among co-infected patients was 9% and the reported time of hospitalization varied between 6.9-20 days. Conclusion: In conclusion, our analysis showed conflicting results regarding the co-infection and its effect on disease severity. The presence of co-infection showed increased risk of severe illness, mortality and hospitalization in some studies and in other studies we did not observe that. The findings in this study support the need for diagnostic testing to identify and treat patients with SARS-CoV-2 co- infection.