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

• 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
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.23687

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,
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, and invasive pulmonary aspergillosis. Large-scale studies are required to better identify opportunistic/secondary/superinfections in COVID-19 patients.