Impact of viral co-infection on clinical outcomes and mortality of COVID-19 patients: a study from Saudi Arabia

Usama E Abu Elhassan; Saad M A Alqahtani; Naif S Al Saglan; Ali Hawan; Khadejah M Alshahrani; Hana S Al-Malih; Mohammed A Alshehri; Faisal S Alqahtani; Fatimah Alshomrani; Roaa S Almtheeb; Ibrahim H E Feteih; Magda S R Abdelwahab; Ibrahim M A Mahmoud

doi:10.4081/mrm.2023.915

Impact of viral co-infection on clinical outcomes and mortality of COVID-19 patients: a study from Saudi Arabia

Multidiscip Respir Med. 2023 May 12;18(1):915. doi: 10.4081/mrm.2023.915. eCollection 2023 Jan 17.

Authors

Affiliations

¹ Department of Internal Medicine, Armed Forces Hospital Southern Region (AFHSR), Khamis Mushayt, Saudi Arabia.
² Department of Pulmonary Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
³ Department of Pathology and Laboratory Medicine, Armed Forces Hospital Southern Region (AFHSR), Khamis Mushayt, Saudi Arabia.
⁴ Department of Internal Medicine, Asir Central Hospital, Abha, Saudi Arabia.
⁵ Infectious Diseases and Notification Unit, Armed Forces Hospital Southern Region (AFHSR), Khamis Mushayt, Saudi Arabia.
⁶ Prince Khalid Bin Sultan Cardiac Center (PKBSCC), Armed Forces Hospital Southern Region (AFHSR), Khamis Mushayt, Saudi Arabia.
⁷ Department of Internal Medicine, Mataria Teaching Hospital, Cairo, Egypt.
⁸ Department of Internal Medicine, Ain Al Khaleej Hospital, Abu Dhabi, United Arab Emirates.
⁹ Department of Anesthesia and Intensive Care, Faculty of Medicine, Cairo University, Cairo, Egypt.
¹⁰ Department of Critical Care, Armed Forces Hospital Southern Region (AFHSR), Khamis Mushayt, Saudi Arabia.
¹¹ Department of Critical Care, Faculty of Medicine, Cairo University, Cairo, Egypt.

Abstract

Background: In COVID-19 patients undetected co-infections may have severe clinical implications associated with prolonged hospitalization, ICU admission, and mortality. Therefore, we aimed to investigate the impact of viral coinfections on the outcomes of hospitalized patients with COVID-19 in a large tertiary Saudi Arabian Hospital.

Methods: A total of 178 adult patients with confirmed SARS-CoV-2 who were hospitalized at the Armed Forces Hospital Southern Region (AFHSR), Saudi Arabia, from March 1^st to June 30^th 2022, were enrolled. Real-time PCR for the detection of viral co‑infections was carried out. Cases (SARS-CoV-2 with viral coinfections) and control (SARS-CoV-2 mono-infection) groups were compared.

Results: 12/178 (7%) of enrolled COVID-19 patients had viral coinfections. 82/178 (46%) of patients were males. 58% of patients had comorbidities. During the study period, 4/12 (33%) and 21/166 (13%) cases and control patients died, p=0.047, respectively. Duration of hospitalization was the only significant independent factor associated with SARS-CoV-2 coinfections, OR 1.140, 95% CI 1.020-1.274, p=0.021.

Conclusions: The findings of this study from a large tertiary Saudi Arabian Center revealed a prevalence of 7% for SARS-CoV-2 viral coinfections. SARS-CoV-2 coinfected patients had a significantly prolonged duration of hospitalization and higher mortality than those with SARS-CoV-2 alone. Future studies are needed.

Keywords: COVID-19; clinical; coinfection; hospitalization; impact; mortality; outcomes; virus.

Grants and funding

Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.