Abstract

Abstract Background After the emergence of SARS-CoV-2 and its worldwide spread, only a few studies have correlated its co-circulation with other respiratory viral pathogens (RVP). The current report aims to identify the pattern of SARS-CoV-2 positivity in individuals co-infected with influenza A (FluA), influenza B (FluB), or respiratory syncytial virus (RSV) in São Paulo, Brazil. Methods Study Population and Characteristics: This study was a retrospective analysis from a clinical laboratory database in São Paulo, Brazil from January 15 to March 10, 2022. Test results for respiratory viral co-infections were recorded for individuals with SARS-CoV-2, FluA, FluB, or RSV. Nasopharyngeal swab samples were evaluated for the molecular diagnosis of respiratory virus infections using a real-time multiplex-PCR panel to search for specific genes for the detection of SARS-CoV-2, FluA, FluB, and RSV. Only samples positive for one or more pathogens (including SARS-CoV-2) were included in the study. We further stratified the specimens by SARS-CoV-2 positivity, comparing those that also tested positive for an RVP in each group. Statistical Analysis: Kruskal-Wallis analysis of variance followed by Dunn’s multiple comparison tests was used. Results with P < 0.05 were considered statistically significant. Georeferencing analysis of SARS-CoV-2 mono-infection or co-infection with another respiratory virus was performed using an online available software application. Results A total of 28 932 samples were positive for at least one RVP, meeting the study criteria. Among those, a total of 93.13% were from individuals diagnosed with SARS-CoV-2 only, 2.99% positive for SARS-CoV-2 and FluA, and 0.99% positive for SARS-CoV-2 and RSV. There was no significant difference observed between genders nor individuals with mono-infection or co-infection. The analysis of age group showed a significant variation in positive cases between SARS-CoV-2 vs SARS-CoV-2 and FluA in the 0 to 10-year-old population (P = 0.017) and between SARS-CoV-2 vs SARS-CoV-2 and RSV in the 0 to 5-year-old population (P = 0.018). The highest number of positive samples for both SARS-CoV-2 and RSV was detected in the southern region of São Paulo (55.7%), compared to the north and east regions (44.3%). Conclusion Differences in diagnostic patterns of COVID-19 compared to other respiratory viral infections RVP co-infections are important for a better understanding of clinical outcomes, improved patient management, and better public health planning.

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