Co-infections in people with COVID-19: A systematic review and meta-analysis
Baskaran, Vadsala Lim, Wei Shen
Baskaran, Vadsala
Lim, Wei Shen
Abstract
Objectives: In previous influenza pandemics, bacterial co-infections have been a major cause of mortality. We aimed to evaluate the burden of co-infections in patients with COVID-19. Method(s): We systematically searched Embase, Medline, Cochrane Library, LILACS and CINAHL for eligible studies published from 1 January 2020 to 17 April 2020. We included patients of all ages, in all settings. The main outcome was the proportion of patients with a bacterial, fungal or viral co-infection. Result(s): Thirty studies including 3834 patients were included. Overall, 7% of hospitalised COVID-19 patients had a bacterial co-infection (95% CI 3-12%, n=2183, I2=92.2%). A higher proportion of ICU patients had bacterial co-infections than patients in mixed ward/ICU settings (14%, 95% CI 5-26, I2=74.7% versus 4%, 95% CI 1-9, I2= 91.7%). The commonest bacteria were Mycoplasma pneumonia, Pseudomonas aeruginosa and Haemophilus influenzae. The pooled proportion with a viral co-infection was 3% (95% CI 1-6, n=1014, I2=62.3%), with Respiratory Syncytial Virus and influenza A the commonest. Three studies reported fungal co-infections. Conclusion(s): A low proportion of COVID-19 patients have a bacterial co-infection; less than in previous influenza pandemics. These findings do not support the routine use of antibiotics in the management of confirmed COVID-19 infection.Copyright © 2020 The British Infection Association
MIDER Authors
Affiliations
Citations
Altmetric:
Date
2020
Type
Article
Subject
Collections
Citation
Lansbury L., Lim B., Baskaran V. and Lim, W.S. (2020) 'Co-infections in people with COVID-19: A systematic review and meta-analysis', Journal of Infection, 81(2), pp. 266–275. doi: 10.1016/j.jinf.2020.05.046 https://doi.org/10.1016/j.jinf.2020.05.046.
Journal / Source Title
DOI
PMID
Publisher
Publisher’s URL
Publisher’s statement
Available to read on the publisher's website here: https://doi.org/10.1016/j.jinf.2020.05.046.