Opportunistic Infections in COVID-19: A Systematic Review and Meta-Analysis

The prevalence, incidence, and characteristics of bacterial infections in patients infected with severe acute respiratory syndrome coronavirus 2 are not well understood and have been raised as an important knowledge gap. Therefore, our study focused on the most common opportunistic infections/second...

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Bibliographic Details
Published in:	Curēus (Palo Alto, CA) Vol. 14; no. 3; p. e23687
Main Authors:	Kurra, Nithin, Woodard, Priyanka Isaac, Gandrakota, Nikhila, Gandhi, Heli, Polisetty, Srinivasa Rao, Ang, Song Peng, Patel, Kinjalben P, Chitimalla, Vishwaj, Ali Baig, Mirza M, Samudrala, Gayathri
Format:	Journal Article
Language:	English
Published:	United States Cureus Inc 31-03-2022 Cureus
Subjects:	Bacteria Bacterial infections Coronaviruses COVID-19 Cytomegalovirus Disease transmission E coli Epidemiology/Public Health Fungal infections Fungi Infectious Disease Internal Medicine Meta-analysis Pneumonia Severe acute respiratory syndrome coronavirus 2 Statistical analysis Streptococcus infections Systematic review Russia opportunistic fungal infection opportunistic infections secondary infections coronavirus-associated pulmonary aspergillosis bacterial coinfection in covid-19 covid-19 covid-19 co-infection respiratory coinfections superinfections sars-cov-2
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Summary:	The prevalence, incidence, and characteristics of bacterial infections in patients infected with severe acute respiratory syndrome coronavirus 2 are not well understood and have been raised as an important knowledge gap. Therefore, our study focused on the most common opportunistic infections/secondary infections/superinfections in coronavirus disease 2019 (COVID-19) patients. This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eligible studies were identified using PubMed/Medline since inception to June 25, 2021. Studies meeting the inclusion criteria were selected. Statistical analysis was conducted in Review Manager 5.4.1. A random-effect model was used when heterogeneity was seen to pool the studies, and the result was reported as inverse variance and the corresponding 95% confidence interval. We screened 701 articles comprising 22 cohort studies which were included for analysis. The pooled prevalence of opportunistic infections/secondary infections/superinfections was 16% in COVID-19 patients. The highest prevalence of secondary infections was observed among viruses at 33%, followed by bacteria at 16%, fungi at 6%, and 25% among the miscellaneous group/wrong outcome. Opportunistic infections are more prevalent in critically ill patients. The isolated pathogens included Epstein-Barr virus, , , , , and invasive pulmonary aspergillosis. Large-scale studies are required to better identify opportunistic/secondary/superinfections in COVID-19 patients.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	2168-8184 2168-8184
DOI:	10.7759/cureus.23687