tetano
Editor, Senior Moderator
Cureus
. 2022 Mar 31;14(3):e23687.
doi: 10.7759/cureus.23687. eCollection 2022 Mar.
Opportunistic Infections in COVID-19: A Systematic Review and Meta-Analysis
Nithin Kurra[SUP] 1 [/SUP], Priyanka Isaac Woodard[SUP] 2 [/SUP], Nikhila Gandrakota[SUP] 3 [/SUP], Heli Gandhi[SUP] 4 [/SUP], Srinivasa Rao Polisetty[SUP] 4 [/SUP], Song Peng Ang[SUP] 5 [/SUP], Kinjalben P Patel[SUP] 6 [/SUP], Vishwaj Chitimalla[SUP] 7 [/SUP], Mirza M Ali Baig[SUP] 8 [/SUP], Gayathri Samudrala[SUP] 9 10 [/SUP]
Affiliations
Abstract
The prevalence, incidence, and characteristics of bacterial infections in patients infected with severe acute respiratory syndrome coronavirus 2 are not well understood and have been raised as an important knowledge gap. Therefore, our study focused on the most common opportunistic infections/secondary infections/superinfections in coronavirus disease 2019 (COVID-19) patients. This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eligible studies were identified using PubMed/Medline since inception to June 25, 2021. Studies meeting the inclusion criteria were selected. Statistical analysis was conducted in Review Manager 5.4.1. A random-effect model was used when heterogeneity was seen to pool the studies, and the result was reported as inverse variance and the corresponding 95% confidence interval. We screened 701 articles comprising 22 cohort studies which were included for analysis. The pooled prevalence of opportunistic infections/secondary infections/superinfections was 16% in COVID-19 patients. The highest prevalence of secondary infections was observed among viruses at 33%, followed by bacteria at 16%, fungi at 6%, and 25% among the miscellaneous group/wrong outcome. Opportunistic infections are more prevalent in critically ill patients. The isolated pathogens included Epstein-Barr virus, Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii, Hemophilus influenza, and invasive pulmonary aspergillosis. Large-scale studies are required to better identify opportunistic/secondary/superinfections in COVID-19 patients.
Keywords: bacterial coinfection in covid-19; coronavirus-associated pulmonary aspergillosis; covid-19; covid-19 co-infection; opportunistic fungal infection; opportunistic infections; respiratory coinfections; sars-cov-2; secondary infections; superinfections.
. 2022 Mar 31;14(3):e23687.
doi: 10.7759/cureus.23687. eCollection 2022 Mar.
Opportunistic Infections in COVID-19: A Systematic Review and Meta-Analysis
Nithin Kurra[SUP] 1 [/SUP], Priyanka Isaac Woodard[SUP] 2 [/SUP], Nikhila Gandrakota[SUP] 3 [/SUP], Heli Gandhi[SUP] 4 [/SUP], Srinivasa Rao Polisetty[SUP] 4 [/SUP], Song Peng Ang[SUP] 5 [/SUP], Kinjalben P Patel[SUP] 6 [/SUP], Vishwaj Chitimalla[SUP] 7 [/SUP], Mirza M Ali Baig[SUP] 8 [/SUP], Gayathri Samudrala[SUP] 9 10 [/SUP]
Affiliations
- PMID: 35505698
- PMCID: PMC9055976
- DOI: 10.7759/cureus.23687
Abstract
The prevalence, incidence, and characteristics of bacterial infections in patients infected with severe acute respiratory syndrome coronavirus 2 are not well understood and have been raised as an important knowledge gap. Therefore, our study focused on the most common opportunistic infections/secondary infections/superinfections in coronavirus disease 2019 (COVID-19) patients. This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eligible studies were identified using PubMed/Medline since inception to June 25, 2021. Studies meeting the inclusion criteria were selected. Statistical analysis was conducted in Review Manager 5.4.1. A random-effect model was used when heterogeneity was seen to pool the studies, and the result was reported as inverse variance and the corresponding 95% confidence interval. We screened 701 articles comprising 22 cohort studies which were included for analysis. The pooled prevalence of opportunistic infections/secondary infections/superinfections was 16% in COVID-19 patients. The highest prevalence of secondary infections was observed among viruses at 33%, followed by bacteria at 16%, fungi at 6%, and 25% among the miscellaneous group/wrong outcome. Opportunistic infections are more prevalent in critically ill patients. The isolated pathogens included Epstein-Barr virus, Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii, Hemophilus influenza, and invasive pulmonary aspergillosis. Large-scale studies are required to better identify opportunistic/secondary/superinfections in COVID-19 patients.
Keywords: bacterial coinfection in covid-19; coronavirus-associated pulmonary aspergillosis; covid-19; covid-19 co-infection; opportunistic fungal infection; opportunistic infections; respiratory coinfections; sars-cov-2; secondary infections; superinfections.