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Meta-Analysis
. 2021 Sep 3:2021:5313832.
doi: 10.1155/2021/5313832. eCollection 2021.

Viral Coinfection among COVID-19 Patient Groups: An Update Systematic Review and Meta-Analysis

Pooneh Malekifar  1 , Reza Pakzad  2   3 , Ramin Shahbahrami  4 , Milad Zandi  4   5 , Ali Jafarpour  6 , Sara Akhavan Rezayat  7 , Samaneh Akbarpour  8 , Alireza Namazi Shabestari  9 , Iraj Pakzad  10 , Elahe Hesari  1 , Abbas Farahani  11 , Saber Soltani  4   5
Affiliations
Meta-Analysis

Viral Coinfection among COVID-19 Patient Groups: An Update Systematic Review and Meta-Analysis

Pooneh Malekifar et al. Biomed Res Int. .

Abstract

Background: Coinfections have a potential role in increased morbidity and mortality rates during pandemics. Our investigation is aimed at evaluating the viral coinfection prevalence in COVID-19 patients.

Methods: We systematically searched scientific databases, including Medline, Scopus, WOS, and Embase, from December 1, 2019, to December 30, 2020. Preprint servers such as medRxiv were also scanned to find other related preprint papers. All types of studies evaluating the viral coinfection prevalence in COVID-19 patients were considered. We applied the random effects model to pool all of the related studies.

Results: Thirty-three studies including 10484 patients were identified. The viral coinfection estimated pooled prevalence was 12.58%; 95% CI: 7.31 to 18.96). Blood viruses (pooled prevalence: 12.48%; 95% CI: 8.57 to 16.93) had the most frequent viral coinfection, and respiratory viruses (pooled prevalence: 4.32%; 95% CI: 2.78 to 6.15) had less frequent viral coinfection. The herpesvirus pooled prevalence was 11.71% (95% CI: 3.02 to 24.80). Also, the maximum and minimum of viral coinfection pooled prevalence were in AMRO and EMRO with 15.63% (95% CI: 3.78 to 33.31) and 7.05% (95% CI: 3.84 to 11.07), respectively.

Conclusion: The lowest rate of coinfection belonged to respiratory viruses. Blood-borne viruses had the highest coinfection rate. Our results provide important data about the prevalence of blood-borne viruses among COVID-19 patients which can be critical when it comes to their treatment procedure.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Study selection process PRISMA flow chart.
Figure 2
Figure 2
Forest plot shows prevalence of viral coinfections among COVID-19 patients according to the random effects approach. Every single article demonstrated by the first author (year) and country. Each line segment's midpoint exhibited the prevalence estimation, the line segment length presents 95% confidence interval (CI) in every study, and the diamond mark points out the pooled estimation.
Figure 3
Figure 3
Pooled prevalence with 95% confidence interval (CI) and heterogeneity indexes of viral coinfections among the COVID-19 patient based on the virus type and different region. The diamond mark exhibits the pooled prevalence and the diamond length shows 95% CI.
Figure 4
Figure 4
Association among (a) age prevalence and (b) sample size with viral coinfection prevalence by applying meta-regression. The circle size shows each study's precision. There is no considerable association with respect to the viral coinfection prevalence with age sample size.
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