Respiratory co-infections with COVID-19 in the Veterans Health Administration, 2020

• DOI: 10.1016/j.diagmicrobio.2021.115312
• Publication Date: 2021-01-20T04:23:57Z
• Authors: Patricia Schirmer; Cynthia Lucero-Ob...; Aditya Sharma; Pooja Sohoni; Gina Oda; Mark Holodniy
• Keywords: Microbiology (medical); Adult; Male; 0301 basic medicine; Adolescent; Veterans Health; Article; Young Adult; 03 medical and health sciences; Influenza, Human; Prevalence; Humans; Child; Respiratory Tract Infections; Aged; Aged, 80 and over; Coinfection; COVID-19; General Medicine; Middle Aged; United States; 3. Good health; United States Department of Veterans Affairs; Infectious Diseases; Child, Preschool; Veterans Health Services; Female

Reporting of Coronavirus disease 2019 (COVID-19) co-infections with other respiratory pathogens has varied. We evaluated 825,280 molecular and/or viral culture respiratory assays within the Veterans Health Administration from September 29, 2019 to May 31, 2020. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected in 10,222 of 174,746 (5.8%) individuals. 30,063 (17.2%) of 174,746 individuals tested for SARS-CoV-2 had additional respiratory pathogen testing; co-infection was identified in 56 of 3757 (1.5%) individuals positive for SARS-CoV-2. Among those negative for SARS-CoV-2, 1022 of 26,306 (3.9%) were positive for at least 1 respiratory pathogen. Compared to COVID-19 mono-infection, individuals with COVID-19 co-infection had lower odds of being female. Compared to non-COVID-19 respiratory pathogen infection, individuals with COVID-19 co-infection had lower odds of being female, were hospitalized more frequently, had higher odds of death, and were younger at death. Our findings suggest COVID-19 co-infections were rare; however, not all COVID-19 patients were concurrently tested for other respiratory pathogens and seasonal decreases in other respiratory pathogens were occurring as COVID-19 emerged.