Coinfection with SARS-CoV-2 and common respiratory pathogens in patients with suspected COVID-19

Abstract

Objective: The clinical symptoms of most patients infected with SARS-CoV-2 are similar to the symptoms of common respiratory viral infection. Our study aims to investigate SARS-CoV-2 and common respiratory viruses in patients with suspected COVID-19. Methods: The test results of 592 patients for multiplex respiratory PCR panel and SARS-CoV-2 RT-PCR between March 2020 and March 2022 were studied and retrospectively evaluated. Common respiratory viral pathogens were detected with the multiplex real-time PCR panel (FTD® Respiratory Pathogens 21 Kit, Fast-Track Diagnostics, Luxembourg). The SARS-CoV-2 Real-Time PCR test was evaluated using the Bio-Speedy SARS-CoV-2 Double Gene RT-qPCR Kit, Bio-Speedy® SARS-CoV-2 Emerging Plus, Diagnovital® HS SARS-CoV-2 Real-Time PCR kit, DS CORONEX COVID-19 Multiplex Real-Time Test Kits. Results: Viral antigen positivity was detected in 63.2% (374/592) of the samples. The single-agent positivity was 46.3% (274/592), the dual-agent positivity was 13.9% (82/592), the triple-agent positivity was 2.9% (17/592), and the quadruple-agent positivity was 0.2% (1/592). In 51.5% of SARS-CoV-2 positive patients (17/33), SARS-CoV-2 positivity was detected alone, while in 48.5% (16/33) multiple respiratory viral agents were detected together. Single virus positivity was found alone in 46% of SARS-CoV-2 negative patients (257/559), and 36.3% (203/559) of the patients presented more than one respiratory viral agent. The most frequent coexistent viruses in SARS-CoV-2 positive patients included human rhinovirus (HRV) (7/16, 21.2%), human bocavirus (HBoV) and respiratory adenoviruses (HADV) (n=3/16, 9.1%), respiratory syncytial virus (RSV) and influenza A (n=2/16%, HPV-6.1%); whereas the most frequent coexistent viruses in the SARS-CoV-2 negative patients were HRV 127 (%37.2), human parainfluenza viruses (HPIV) 1-4 81 (%23.8), RSV A 76 (%22.3), HboV 47 (%13.8) and HADV 38 (%11.1). Conclusion: In our study, coexisting viral respiratory infection agents were detected higher in SARS-CoV-2 positive patients. The investigation of multiple coexisting viral agents in patients who are considered to have respiratory tract viral infection will help to implement the correct treatment approach, particularly throughout the ongoing COVID-19 pandemic. © (2024), (Refik Saydam National Public Health Agency (RSNPHA)). All Rights Reserved.