Recently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiologic agent of coronavirus disease 2019 (COVID-19), has led to a worldwide pandemic with millions of infected patients. Alteration in humans’ microbiota was also reported in COVID-19 patients. The alteration in human microbiota may contribute to bacterial or viral infections and affect the immune system. Moreover, human’s microbiota can be altered due to SARS-CoV-2 infection, and these microbiota changes can indicate the progression of COVID-19. While current studies focus on the gut microbiota, it seems necessary to pay attention to the lung microbiota in COVID-19. This study is aimed at reviewing respiratory microbiota dysbiosis among COVID-19 patients to encourage further studies on the field for assessment of SARS-CoV-2 and respiratory microbiota interaction.
Background The pandemic of SARS COV-2 raised the attention toward bacterial coinfection and their role in COVID-19 disease. This study aims to systematically review and identify the pooled prevalence of the bacterial coinfection in the related articles. Methods A comprehensive search was conducted in international databases, including Medline, Scopus, Web of Science, and Embase, to identify the articles on the prevalence of Bacterial coinfections in COIVD-19 patients from December 1, 2019, until December 30, 2020. All observational epidemiological studies that evaluated the prevalence of bacterial coinfections in COVID-19 patients included without any restriction. Results Forty two studies including total sample size of 54695 were included in the analysis. The pooled estimate for prevalence of bacterial coinfections was 20.97% (95% CI: 15.95 to 26.46) the pooled prevalence of bacterial coinfections was 5.20% (95% CI: 2.39 to 8.91) for Respiratory subtype and 4.79% (95% CI: 0.11 to 14.61) for Gastrointestinal subtype. The pooled prevalence for Eastern Mediterranean Regional Office (EMRO) and South-East Asia Regional Office (SEARO) was 100 % (95% CI: 82.35 to 100.00) and 2.61 % (95% CI: 1.74 to 3.62). Conclusion This rate of coinfection poses a great danger toward patients especially those in critical condition. Although there are multiple complication and adverse effect related to extensive use of antibiotics to treat COVID-19 patients but it seems there is no other option except the applying them and it needs to be done carefully.
Microbial coinfections can increase the morbidity and mortality rates of viral respiratory diseases. Therefore, this study aimed to determine the pooled prevalence of fungal coinfections in coronavirus disease 2019 (COVID-19) patients. Web of Science, Medline, Scopus, and Embase were searched without language restrictions to identify the related research on COVID-19 patients with fungal coinfections from December 1, 2019, to December 30, 2020. A random-effects model was used for analysis. The sample size included 2,246 patients from 8 studies. The pooled prevalence of fungal coinfections was 12.60%. The frequency of fungal subtype coinfections was 3.71% for Aspergillus, 2.39% for Candida, and 0.39% for other. The World Health Organization's Regional Office for Europe and Regional Office for Southeast Asia had the highest (23.28%) and lowest (4.53%) estimated prevalence of fungal coinfection, respectively. Our findings showed a high prevalence of fungal coinfections in COVID-19 cases, which is a likely contributor to mortality in COVID-19 patients. Early identification of fungal pathogens in the laboratory for COVID-19 patients can lead to timely treatment and prevention of further damage by this hidden infection.
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