Abstract
Background: Co-infections of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with respiratory viruses, bacteria and fungi have been reported to cause a wide range of illness. Objectives: We assess the prevalence of co-infection of SARS-CoV-2 with seasonal respiratory viruses, document the respiratory viruses detected among individuals tested for SARS-CoV-2, and describe characteristics of individuals with respiratory virus co-infection detected. Methods: Specimens included in this study were submitted as part of routine clinical testing to Public Health Ontario Laboratory from individuals requiring testing for SARS-CoV-2 and/or seasonal respiratory viruses. Results: Co-infection was detected in a smaller proportion (2.5%) of individuals with laboratory confirmed SARS-CoV-2 than those with seasonal respiratory viruses (4.3%); this difference was not significant. Individuals with any respiratory virus co-infection were more likely to be younger than 65 years of age and male than those with single infection. Those with SARS-CoV-2 co-infection manifested mostly mild respiratory symptoms. Conclusions: Findings of this study may not support routine testing for seasonal respiratory viruses among all individuals tested for SARS-CoV-2, as they were rare during the study period nor associated with severe disease. However, testing for seasonal respiratory viruses should be performed in severely ill individuals, in which detection of other viruses may assist with patient management.
Highlights
IntroductionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19) was first identified in December 2019 in Wuhan, China, and has progressively spread, resulting in a global pandemic [1]
Testing for seasonal respiratory viruses is not usually performed for patients seen in ambulatory/outpatient settings, or those seen in emergency rooms (ER), it is provided on special request
Co-infection was detected in a smaller proportion (2.5%) of individuals with laboratory confirmed SARS-CoV-2 infection than in individuals with seasonal respiratory viruses
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19) was first identified in December 2019 in Wuhan, China, and has progressively spread, resulting in a global pandemic [1]. In Ontario, Canada, the first COVID-19 case was identified on 22 January 2020, with the number of daily cases peaking in the second week of April, during the first pandemic wave [2]. As of 22 May 2020, approximately 5 million cases and 300,000 deaths were reported worldwide, including more than 80,000 cases and almost 6000 deaths in Canada [3]. Co-infections of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) with respiratory viruses, bacteria and fungi have been reported to cause a wide range of illness
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