Impact of COVID-19 in Patients with Concurrent Co-Infections: A Systematic Review and Meta-Analyses

Abstract

Background: The burden and impact of secondary superadded infections in critically ill coronavirus disease (COVID-19) patients is widely acknowledged. However, there is a dearth of information regarding the impact of COVID-19 in patients with tuberculosis, HIV, chronic hepatitis, and other concurrent infections. This review was conducted to evaluate the consequence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in patients with concurrent co-infections based on the publications reported to date.Methods: An extensive comprehensive screening was conducted using electronic databases up to 3rd September 2020 after obtaining registration with PROSPERO (CRD420202064800). The observational studies or interventional studies in English, evaluating the impact of SARS-CoV-2 in patients with concurrent infections are included for the meta-analyses.Results: Our search retrieved 20 studies, with a total of 205,702 patients. Patients with Tuberculosis (RR =2.10, 95% CI: 1.75 to 2.51, I 2 =0%), Influenza (RR =2.04, 95% CI: 0.15 to 28.25, I 2 =99%) have an increased risk of mortality during a co-infection with SARS-CoV-2. No significant impact is found in people living with HIV (RR =0.99, 95% CI: 0.82 to 1.19, I 2 =30%), Chronic hepatitis (RR =1.15, 95% CI: 0.73 to 1.81, I 2 =10%). Several countries (Brazil, Paraguay, Argentina, Peru, Colombia, and Singapore) are on the verge of a Dengue co epidemic (cumulative 878496 and 5028380 cases of Dengue and Covid-19 respectively).Conclusions: The impact of COVID-19 in patients of concurrent infections with either Tuberculosis or Influenza is detrimental. The clinical outcomes of COVID-19 in HIV or Chronic hepatitis patients are comparable to COVID-19 patients without these concurrent infections.Funding Statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Declaration of Interests: None.