ABSTRACT
Background: Early studies suggested that co-infections were rare in the COVID-19 (CV19) pandemic which might have led to initial misdiagnosis. Despite their importance in the respiratory diseases' severity, co-infections are understudied and their role in the course of the disease needs to be characterized. Aim: To study co-infections between novel coronavirus (nCoV) and other pathogens. Methods: The authors performed a retrospective analysis (using Mann-Whitney U and Fisher Exact test) of CV19 patients (pts) admitted to a Portuguese community hospital ward between 15/03 and 15/05/2020. Most of these pts were also tested for other pathogens. Results: 203 CV19 suspected pts were admitted, 11,33% (n=23) were confirmed. The mean age was 72.09 ± 16.8 years and most patients were male (56.5%). The mortality rate was 21.7% (n=5). Co-infection was present in 39% (n=9) pts. One third had other virus identified on the nasal swab (two Rhinovirus/Enterovirus and one Metapneumovirus), one third had a positive urine antigen for Pneumococcus, and one third had positive blood cultures for other bacteria. The age of co-infected pts was significantly higher than non-co-infected (p=0.046). Cardiovascular disease (heart failure and arrythmia) and obesity were associated with the presence of co-infection (p=0.009 and 0.019, respectively). Mortality rate tended to be higher in co-infected pts although this finding was not statistically significant (p=0.056). Discussion: In this study, co-infections between nCOV and other pathogens were influenced by age and the presence of comorbidities. Co-infections might have a noteworthy impact in the course of COVID-19 and future studies are needed to accurately assess its burden.