Bacterial and fungal coinfections among patients with COVID-19 in Zanjan, Northwest of Iran; a single-center observational with meta-analysis of the literature

Hamid Morovati; Saba Eslami; Hesam Farzaneh Bonab; Mohammad Kord; Sima Darabian

doi:10.18502/ijm.v14i5.10955

Hamid Morovati Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Saba Eslami Central Research Laboratory, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Hesam Farzaneh Bonab Department of Medical Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
Mohammad Kord Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Sima Darabian Department of Medical Parasitology and Mycology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran

DOI: https://doi.org/10.18502/ijm.v14i5.10955

Keywords: COVID-19; Secondary infection; Nosocomial infection

Abstract

Background and Objectives: There is a poor understanding about the prevalence and characteristics of secondary bacterial and fungal infections among Coronavirus diseases 2019 (COVID-19) superinfection in hospitalized patients.

Materials and Methods: Four hundred COVID-19-proven patients were enrolled in this study. Nasal swabs for molecular assay (Real-time PCR) and sputum samples for further microbiological assays were collected. Following a broad-spectrum search, a meta-analysis was performed using StatsDirect software (version 2.7.9) according to the DerSimonian and Laird method applying the random-effects models.

Results: Streptococcus spp. (21.5%) and Staphylococcus spp. (16.7%) had the highest prevalence of bacterial coinfection among the COVID-19 patients,while Acinetobacter spp. had the lowest prevalence (4.2%). Among fungal coinfections, Candida albicans was the most prevalent (6.7%), and Aspergillus spp.was the lowest (2%). Males, elderly patients, patients with a history of underlying diseases and drug use, patients who showed acute clinical symptoms, andpatients with a pro- longed hospital stay had a higher incidence of secondary infections (P-value <0.05). The pooled prevalence for bacterial and fungal coinfections was 33.52% (95% CI: 18.12 to 50.98; I2: 99.4%; P-value: <0.0001).

Conclusion: We suggest designing additional research with a larger target population and diagnostic molecular analyses to depict a more realistic view of the coinfection status.