- •An increased use of multiplex polymerase chain reaction–based assays has challenged the notion of a single respiratory pathogen always being responsible for a given disease.
- •Rates of coinfection between severe acute respiratory syndrome coronavirus 2 and other respiratory viruses is highly variable based on etiology and patient population.
- •Rates of coinfection or superinfection with bacteria are generally lower in patients with coronavirus disease 2019 than for those with influenza or respiratory syncytial virus.
- •Higher rates of bacterial and fungal pneumonia in ventilated patients with coronavirus disease 2019 in the intensive care unit warrants increased diagnostic testing and empirical antibiotic therapy.
- •Low rates of community-acquired respiratory coinfections, and higher rates of antimicrobial resistance, warrant greater antibiotic stewardship for patients with nonsevere coronavirus disease 2019.
|Coinfections||Geography||Patient Population||Diagnostic Method for Coinfected Agents||No. of Patients||No. of Coinfected Case||Coinfection Rate||Reference|
|SARS-CoV-2 coinfected with influenza A/B||China||Aged ≥ 50 y||IgM serology||213||97||45.5%||Cheng et al,|
|Spain||Adults||NAAT||255||7||2%–8%||Garcia-Vidal et al,|
|Japan||Adults||NAAT||298||28||9.4%||Ishiguro et al,|
|USA||Adults||NAAT||116||1||0.9%||Kim et al,|
|Turkey||Adults||Direct fluorescent antibody||1103||6||0.5%||Ozaras et al,|
|USA||Adults||NAAT||255||58||22.8%||Rizzo et al,|
|China||Children||NAAT||34||1||2.9%||Wu et al,|
|China||Adults||NAAT||145||2||1.4%||Xiang et al,|
|China||Adults||IgM serology||307||176||57.3%||Yue et al,|
|SARS-CoV-2 coinfected with RSV||Spain||Adults||NAAT||256||1||0.4%||Garcia-Vidal et al,|
|USA||Adults||NAAT||116||6||5.2%||Kim et al,|
|USA||Children||NAAT||713||75||10.5%||Wanga et al,|
Characteristics and clinical outcomes of children and adolescents aged <18 years hospitalized with COVID-19 - six hospitals, United States, July-August 2021 [published correction appears in MMWR Morb Mortal Wkly Rep. 2022 Feb 04;71(5):185].
MMWR Morb Mortal Wkly Rep. 2021; 70: 1766-1772
|China||Children||NAAT||34||3||8.8%||Wu et al,|
|Community-acquired coinfections||Spain||Adults||Culture||989||25||2.5%||Garcia-Vidal et al,|
|Sweden||Adults||Culture, NAAT antigen||1243||46||4.0%||Hedberg et al,|
|USA||Adults||Culture, NAAT antigen||1705||59||3.5%||Vaughn et al,|
|Community-acquired coinfections (72 h)||USA||Adults||Culture||3028||183||6.0%||Kubin et al,|
|Community-acquired pneumonia||USA||Adults||Culture, NAAT antigen||1705||26||1.7%||Vaughn et al,|
|USA||Adults||Culture||3796||35||0.9%||Weidmann et al,|
|Health care–associated superinfections (>72 h)||USA||Adults||Culture||3028||350||11.6%||Kubin et al,|
|Hospital-acquired superinfections||Spain||Adults||Culture||989||38||3.8%||Garcia-Vidal et al,|
|Ventilator-associated lower respiratory tract superinfections||Sweden||Intubated Adults||Culture||426||129||29.4%||Hedberg et al,|
|Ventilator-associated pneumonia||USA||Intubated Adults||Culture||631||246||39.0%||Weidmann et al,|
Respiratory viral coinfections
- Tan J.
- Liu S.
- Zhuang L.
- et al.
Prevalence of respiratory viral coinfections
Viral coinfection in adults
Viral coinfection in children
- Wanga V.
- Gerdes M.E.
- Shi D.S.
- et al.
Clinical outcomes of respiratory viral coinfections
Coinfection with influenza
Coinfection with Respiratory Syncytial Virus
- Wanga V.
- Gerdes M.E.
- Shi D.S.
- et al.
Virological mechanisms that determine viral persistence or exclusion during coinfections
Viral competition for resources in the respiratory tract
Epithelial and organ damage
Impact on the pattern of immune responsiveness
Bacterial coinfection in the setting of respiratory viral illness
Influenza-associated bacterial coinfection
RSV-associated bacterial coinfection
SARS-CoV-2–associated bacterial coinfection
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