BMC Infectious Diseases (Feb 2023)

The clinical outcomes of COVID-19 critically ill patients co-infected with other respiratory viruses: a multicenter, cohort study

  • Khalid Al Sulaiman,
  • Ohoud Aljuhani,
  • Hisham A. Badreldin,
  • Ghazwa B. Korayem,
  • Abeer A. Alenazi,
  • Ahlam H. Alharbi,
  • Albandari Alghamdi,
  • Alaa Alhubaishi,
  • Ali F. Altebainawi,
  • Mohammad Bosaeed,
  • Rand Alotaibi,
  • Ahad Alawad,
  • Nirvana Alnajjar,
  • Khalid Bin Saleh,
  • Walaa A. Sait,
  • Samiah Alsohimi,
  • Meshari M. Alanizy,
  • Sarah A. Almuqbil,
  • Ibrahim Al Sulaihim,
  • Ramesh Vishwakarma,
  • Mai Alalawi,
  • Fatimah Alhassan,
  • Suliman Alghnam

DOI
https://doi.org/10.1186/s12879-023-08010-8
Journal volume & issue
Vol. 23, no. 1
pp. 1 – 8

Abstract

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Abstract Background Previous studies have shown that non-critically ill COVID-19 patients co-infected with other respiratory viruses have poor clinical outcomes. However, limited studies focused on this co-infections in critically ill patients. This study aims to evaluate the clinical outcomes of critically ill patients infected with COVID-19 and co-infected by other respiratory viruses. Methods A multicenter retrospective cohort study was conducted for all adult patients with COVID-19 who were hospitalized in the ICUs between March, 2020 and July, 2021. Eligible patients were sub-categorized into two groups based on simultaneous co-infection with other respiratory viruses throughout their ICU stay. Influenza A or B, Human Adenovirus (AdV), Human Coronavirus (i.e., 229E, HKU1, NL63, or OC43), Human Metapneumovirus, Human Rhinovirus/Enterovirus, Middle East Respiratory Syndrome Coronavirus (MERS-CoV), Parainfluenza virus, and Respiratory Syncytial Virus (RSV) were among the respiratory viral infections screened. Patients were followed until discharge from the hospital or in-hospital death. Results A total of 836 patients were included in the final analysis. Eleven patients (1.3%) were infected concomitantly with other respiratory viruses. Rhinovirus/Enterovirus (38.5%) was the most commonly reported co-infection. No difference was observed between the two groups regarding the 30-day mortality (HR 0.39, 95% CI 0.13, 1.20; p = 0.10). The in-hospital mortality was significantly lower among co-infected patients with other respiratory viruses compared with patients who were infected with COVID-19 alone (HR 0.32 95% CI 0.10, 0.97; p = 0.04). Patients concomitantly infected with other respiratory viruses had longer median mechanical ventilation (MV) duration and hospital length of stay (LOS). Conclusion Critically ill patients with COVID-19 who were concomitantly infected with other respiratory viruses had comparable 30-day mortality to those not concomitantly infected. Further proactive testing and care may be required in the case of co-infection with respiratory viruses and COVID-19. The results of our study need to be confirmed by larger studies.

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