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. 2022 Feb 21;14(2):446.
doi: 10.3390/v14020446.

Prevalence and Clinical Impact of Coinfection in Patients with Coronavirus Disease 2019 in Korea

Seri Jeong  1 , Nuri Lee  1 , Yeeun Park  1 , Jaehong Kim  1 , Kibum Jeon  2 , Min-Jeong Park  1 , Wonkeun Song  1
Affiliations

Prevalence and Clinical Impact of Coinfection in Patients with Coronavirus Disease 2019 in Korea

Seri Jeong et al. Viruses. .

Abstract

Coinfection rates with other pathogens in coronavirus disease 2019 (COVID-19) varied during the pandemic. We assessed the latest prevalence of coinfection with viruses, bacteria, and fungi in COVID-19 patients for more than one year and its impact on mortality. A total of 436 samples were collected between August 2020 and October 2021. Multiplex real-time PCR, culture, and antimicrobial susceptibility testing were performed to detect pathogens. The coinfection rate of respiratory viruses in COVID-19 patients was 1.4%. Meanwhile, the rates of bacteria and fungi were 52.6% and 10.5% in hospitalized COVID-19 patients, respectively. Respiratory syncytial virus, rhinovirus, Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans were the most commonly detected pathogens. Ninety percent of isolated A. baumannii was non-susceptible to carbapenem. Based on a multivariate analysis, coinfection (odds ratio [OR] = 6.095), older age (OR = 1.089), and elevated lactate dehydrogenase (OR = 1.006) were risk factors for mortality as a critical outcome. In particular, coinfection with bacteria (OR = 11.250), resistant pathogens (OR = 11.667), and infection with multiple pathogens (OR = 10.667) were significantly related to death. Screening and monitoring of coinfection in COVID-19 patients, especially for hospitalized patients during the pandemic, are beneficial for better management and survival.

Keywords: COVID-19; SARS-CoV-2; coinfection; mortality; prevalence; resistance.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Monthly detection of coinfecting viruses in patients with COVID-19. Flu B, influenza B; HBoV, bocavirus; HRV, rhinovirus; RSV, respiratory syncytial virus.
Figure 2
Figure 2
Distribution of coinfecting viruses by age group in patients with COVID-19. Flu B, influenza B; HBoV, bocavirus; HRV, rhinovirus; RSV, respiratory syncytial virus.
Figure 3
Figure 3
Monthly detected bacteria causing nosocomial infection in patients with COVID-19.
Figure 4
Figure 4
Distribution of bacteria causing nosocomial infection by age group in patients with COVID-19.
Figure 5
Figure 5
Monthly detected fungi causing nosocomial infection in patients with COVID-19.
Figure 6
Figure 6
Distribution of infecting fungi by age group in patients with COVID-19.
See this image and copyright information in PMC

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