Abstract
The outbreak of COVID-19 has significantly changed the epidemiology of respiratory tract infection in several ways. The implementation of non-pharmaceutical interventions (NPIs) including universal masking, hand hygiene, and social distancing not only resulted in a decline in reported SARS-CoV-2 cases but also contributed to the decline in the non-COVID-19 respiratory tract infection-related hospital utilization. Moreover, it also led to the decreased incidence of previous commonly encountered respiratory pathogens, such as influenza and Streptococcus pneumoniae. Although antimicrobial agents are essential for treating patients with COVID-19 co-infection, the prescribing of antibiotics was significantly higher than the estimated prevalence of bacterial co-infection, which indicated the overuse of antibiotics or unnecessary antibiotic use during the COVID-19 pandemic. Furthermore, inappropriate antimicrobial exposure may drive the selection of drug-resistant microorganisms, and the disruption of infection control in COVID-19 setting measures may result in the spread of multidrug-resistant organisms (MDROs). In conclusion, NPIs could be effective in preventing respiratory tract infection and changing the microbiologic distribution of respiratory pathogens; however, we should continue with epidemiological surveillance to establish updated information, antimicrobial stewardship programs for appropriate use of antibiotic, and infection control prevention interventions to prevent the spread of MDROs during the COVID-19 pandemic.
Highlights
It has been more than 2 years since the first outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China, the negative impact of coronavirus disease 2019 (COVID-19) on global health is continuing [1]
The updated meta-analysis of 34 studies involved 8901 cases, in which ventilation-associated pneumonia (VAP) was reported in 48.15% mechanically ventilated COVID-19 patients and the risk of VAP was higher in COVID-19 patients than other non-SARS-CoV-2 viral pneumonia (OR, 2.33; 95% CI, 1.75–3.11; I2 = 15%) [74]
non-pharmaceutical interventions (NPIs) including universal masking, hand hygiene, and social distancing resulted in the decline in reported SARS-CoV-2 cases and contributed to the decline in non-COVID-19 respiratory tract infection-related hospital utilization
Summary
It has been more than 2 years since the first outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China, the negative impact of coronavirus disease 2019 (COVID-19) on global health is continuing [1]. Despite the implementation of the abovementioned NPIs not being able to completely stop the spread of COVID-19, these measures did result in a significant reduction in the prevalence of many other infectious diseases, respiratory tract infections [6–11]. Before the emergence of COVID-19, pneumonia, including community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP)/ventilation-associated pneumonia (VAP), was one of the most common infectious diseases, and could cause major. According to the estimation of the Global Burden of Diseases (GBD) study in 2016, 336.5 million cases of lower respiratory tract infections (LRTIs) developed. Most of this knowledge was based on studies prior to the COVID-19 pandemic and the emergence of SARS-CoV-2 could significantly change the whole picture of respiratory tract infections in many ways, including epidemiology, microbiological distribution, antibiotic consumption, and antimicrobial resistance. We conducted this review to provide an update and comprehensive information about respiratory tract infections during the COVID-19 pandemic
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