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How often does COVID-19 co-infect with other viruses?

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COVID-19 is typically diagnosed using either a reverse transcriptase-polymerase chain reaction (RT-PCR) assay or a lateral flow device. Numerous countries supply lateral flow devices for free or at a reduced cost to their citizens.

Additionally, several governments mandate testing in order to travel internationally. However, this data set contains information on infection with SARS-CoV-2.

A team of scientists at the Universidad de São Francisco has been analyzing data from COVID-19 patients who were also screened for other disorders. The presence of these disorders may significantly alter some prognoses. Their research was published in Diagnostic Microbiology and Infectious Disease.

The researchers gathered data from the Sao Paulo Research Foundation’s shared COVID-19 database, which enables information to be shared across five Sao Paulo health agencies. They classified individuals by gender and age range.

RT-PCR was used to confirm SARS-CoV-2 infection, while several other infections were also scanned concurrently, including Influenza A viruses (-H1N1 and other subtypes), Influenza B virus, Human Respiratory Syncytial Virus (HRSV), Human Parainfluenza Viruses Type I (HPIV-1), II (HPIV-2), III (HPIV-3), IV (HPIV-4), Rhinovirus/Enterovirus (RV/EV), Adenoviruses (ADVs), Human Metapneumovirus (hMPV), Human Coronavirus (HCoV)-229E, HCoV-HKU1, HCoV-NL63, and HCoV-OC43.

Additionally, the researchers examined urine for four bacterial species and sought to detect yeasts. The researchers compared the proportions of respiratory infections between different groups using the Pearson Chi-square or Fisher Exact Test, while analyzing relationships between variables using the odds ratio.

The researchers collected data on 73,897 individuals in all, approximately 17,000 of whom tested positive for SARS-CoV-2. Additionally, 8.44 percent of individuals were checked for at least one additional pathogen.

Individuals between age 25 to 61 years and were nearly evenly split between males and females. There were 850 testing for Influenza A virus, 728 tests for Influenza B virus, 780 tests for Influenza A-H1N1 virus, 778 tests for M. pneumoniae, 775 tests for HSRV, 3,768 tests for C. pneumoniae, 767 tests for RV/EV, 304 for yeasts in urine, and 935 for S. pyogenes, and 766 for ADVs, B. pertussis, HCoV-229E, HCoV-HKU1, HCoV-NL63, HCoV-OC43, HPIV-1, -2, -3, -4 and hMPV.

RV/EV was the most often found viral group, reported in 594 individuals. Influenza B was diagnosed in 199 people, whereas Influenza A-H1N1 and other Influenza A subtypes were found in 115 and 105 people, respectively.

The most often identified bacterial species was S. pyogenes, which was detected in 121 individuals, eight of whom were also positive for COVID-19. C. pneumoniae was detected in twenty people who tested negative for COVID-19.

M. pneumoniae was detected in ten patients, two of whom were COVID-19 positive. Four persons tested positive for B. pertussis, one of whom had COVID-19. Although only 17 individuals had yeast in their urine, this was connected with testing positive for COVID-19.

By and large, the majority of individuals who tested negative for COVID-19 tested positive for another microbe, with the vast majority being between the ages of 25 and 60. However, this was by far the largest age group.

A total of 150 cases of identification of another microbe were linked to COVID-19. One of them tested positive for a total of 16 microbes, while the researchers caution against this finding, speculating that it could be the result of a database error.

Although these individuals are too diverse to address individually, the majority of subjects who tested positive for an alternate respiratory virus tested negative for SARS-CoV-2, and nine viruses were associated with a decreased chance of developing the disease. According to scientists, this could be due to immunological activity or viral competition for cell receptors.

Over 1,300 COVID-19 cases were discovered alongside another virus, with RV/EV being the most prevalent. The researchers demonstrate that having yeast in the urine is connected with testing positive for COVID-19, which may be owing to immunological dysfunction induced by the disease, which facilitates the development of fungal infections.

The researchers emphasize that their findings are exploratory at the moment; nonetheless, they believe that this knowledge could be incredibly useful upon additional analysis.

It could be extremely beneficial for healthcare providers to know which other respiratory viruses and bacteria are likely to be harmful to COVID-19 patients, as this information could contribute to optimizing treatment for these patients.

Source: doi:10.1016/j.diagmicrobio.2021.115576.

Image Credit: Getty

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