| Title |
Bacterial and viral coinfections in adult patients hospitalized with COVID-19 throughout the pandemic: a multinational cohort study in the EuCARE project / |
| Authors |
Hedberg, Pontus ; Serwin, Karol ; Greco, Maria Francesca ; Pereira, Joana P. V ; Juozapaitė, Dovilė ; De Benedittis, Sara ; Bai, Francesca ; Luebke, Nadine ; Wienemann, Tobias ; Fanti, Iuri ; Koenig, Florian ; Pfeifer, Nico ; Kaiser, Rolf ; Zazzi, Maurizio ; Cozzi-Lepri, Alessandro ; Naumovas, Daniel ; Marchetti, Giulia ; Parczewski, Milosz ; Jensen, Bjoern-Erik Ole ; Incardona, Francesca ; Soennerborg, Anders ; Naucler, Pontus |
| DOI |
10.1093/infdis/jiaf167 |
| Full Text |
|
| Is Part of |
Journal of infectious diseases.. Oxford : Oxford University Press. 2025, Early Access, p. [1-11].. ISSN 0022-1899. eISSN 1537-6613 |
| Keywords [eng] |
antimicrobial stewardship ; coinfection ; mortality ; COVID-19 ; SARS-CoV-2 |
| Abstract [eng] |
Background Limited evidence exists on how bacterial and viral coinfections have developed since the SARS-CoV-2 Omicron variant emerged. We investigated whether community-onset coinfections in adult patients hospitalized with COVID-19 differed during the wild type, Alpha, Delta, and Omicron periods and whether such coinfections were associated with an increased risk of mortality. Methods We conducted a multinational cohort study including COVID-19 hospitalizations until 30 April 2023 in 5 European countries. The outcome was bacterial and viral coinfections based on 5 test modalities. Variant periods were compared with regard to occurrences of coinfections and risk ratios for coinfections (Omicron vs pre-Omicron), as well as association with in-hospital mortality (Omicron vs pre-Omicron). Results A total of 29 564 cases were included: 12 601 wild type, 5256 Alpha, 2433 Delta, and 9274 Omicron. The coinfection rate was 2.6% (327/12 601) for wild type, 2.0% (105/5256) for Alpha, 3.2% (77/2433) for Delta, and 7.9% (737/9274) for Omicron. Omicron had a significantly increased risk ratio of coinfection when compared with preceding variants (1.88 [95% CI, 1.53–2.32], P < .001). These results were consistent across several subgroup analyses. An increased occurrence (19% [232/1246] vs 11% [3042/28 318]) and adjusted risk (1.69 [95% CI, 1.49–1.91], P < .001) of in-hospital mortality were observed in patients with a verified coinfection as compared with patients without a coinfection. Conclusions Bacterial and viral coinfections were more prevalent during the Omicron period as compared with preceding variants. Such coinfections were associated with an increased risk of in-hospital mortality, calling for sustained monitoring and clinical vigilance. |
| Published |
Oxford : Oxford University Press |
| Type |
Journal article |
| Language |
English |
| Publication date |
2025 |
| CC license |
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