Narrative review of factors associated with SARS-CoV-2 coinfection in Middle Eastern countries and the need to vaccinate against preventable diseases

Abstract

This review evaluated the frequency of, and outcomes associated with, bacterial, fungal, and viral coinfection with SARS-CoV-2 in Middle Eastern countries via a PubMed search through February 2023. Ninety articles reported bacterial (n = 57), fungal (n = 32), and viral (n = 32) coinfections. High frequencies of coinfection with COVID-19 were identified, with rates and outcomes varying by setting, pathogen, surveillance/detection method, population characteristics, and drug-resistance status. Mortality rates were higher in patients with community-acquired (10.0 −42.9 %) and hospital-acquired (51.5 −66 %) bacterial coinfection versus those without (10.5 −21.7 %). Outcomes were worse with than without fungal coinfection, and fatality rates with mucormycosis coinfection reached 66.7 %. Outcomes with viral coinfection were highly variable; however, some data suggested a positive corelation between COVID-19 severity and influenza A and adenovirus coinfection. The negative outcomes associated with bacterial, fungal and some viral coinfections in individuals with COVID-19 support regular vaccination against vaccine-preventable diseases caused by these pathogens, especially among at-risk populations.

Keywords

• Bacteria
• Coinfection
• COVID-19
• Fungi
• Middle East
• SARS-CoV-2 virus