Coinfection of other respiratory pathogens and HIV in COVID-19 patients: Is there a pattern?

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) has led to the elaboration of multiple studies to increase knowledge and understanding, hence, having the ability to accomplish an adequate and timely diagnosis and give an optimal treatment according to the patient's condition. The clinical manifestations of COVID-19 pose a series of challenges both in understanding and delimiting the disease secondary to the SARS-CoV-2 infection. This is due to the fact that the main axis of this disease is the endothelial compromise and the production of a "cytokine storm," triggering multiple organ failure and death. Given that a complete understanding of its pathophysiology and clinical behavior has not yet been achieved, we wondered if coinfection with other respiratory viruses modifies its performance and outcomes described so far. A literature search was performed, obtaining 68 articles, of which 25 were analyzed. The analysis showed us that there is a high variety both in the types of associated infections and in the clinical behavior of patients and their outcomes. Therefore, we consider that the search for other infections should be performed exhaustively, especially in those cases that may be susceptible to treatment such as Influenza A, human immunodeficiency virus, or bacterial infections. As well as optimize the analysis of these cases and establish if there are characteristics that allow establishing the possibility of carrying an additional infection to that of SARS-CoV-2 and the implications for the management and prognosis of the patient.

Are we using the right method to estimate the number of COVID-19 cases?

The great concern stemming from the current COVID-19 pandemic has been a challenge for governments and international organizations around the world. Likewise, the diagnosis has played an important role in the prioritization processes, in particular, for the identification and follow-up of cases. In this context, PCR and serological tests have become the international standard; however, some limitations, as well as the scope of these techniques, must be understood in terms of population numbers. This comment seeks to clarify the interpretation of the results of these tests from a public health perspective.