全球 COVID-19 患者中微生物共感染的流行情况:一项全面更新的系统评价和荟萃分析。
Worldwide prevalence of microbial agents' coinfection among COVID-19 patients: A comprehensive updated systematic review and meta-analysis.
机构信息
Department of Epidemiology, Faculty of Health, Ilam University Medical Sciences, Ilam, Iran.
Department of Epidemiology, School of Public Health, Tehran University Medical Sciences, Tehran, Iran.
出版信息
J Clin Lab Anal. 2022 Jan;36(1):e24151. doi: 10.1002/jcla.24151. Epub 2021 Dec 1.
BACKGROUND
To provide information about pathogens' coinfection prevalence with SARS-CoV-2 could be a real help to save patients' lives. This study aims to evaluate the pathogens' coinfection prevalence among COVID-19 patients.
METHOD
In order to find all of the relevant articles, we used systematic search approach. Research-based databases including PubMed, Web of Science, Embase, and Scopus, without language restrictions, were searched to identify the relevant bacterial, fungal, and viral coinfections among COVID-19 cases from December 1, 2019, to August 23, 2021. In order to dig deeper, other scientific repositories such as Medrxiv were probed.
RESULTS
A total of 13,023 studies were found through systematic search. After thorough analysis, only 64 studies with 61,547 patients were included in the study. The most common causative agents of coinfection among COVID-19 patients were bacteria (pooled prevalence: 20.97%; 95% CI: 15.95-26.46; I : 99.9%) and less frequent were virus coinfections (pooled prevalence: 12.58%; 95% CI: 7.31-18.96; I : 98.7%). The pooled prevalence of fungal coinfections was also 12.60% (95% CI: 7.84-17.36; I : 98.3%). Meta-regression analysis showed that the age sample size and WHO geographic region did not influenced heterogeneity.
CONCLUSION
We identified a high prevalence of pathogenic microorganism coinfection among COVID-19 patients. Because of this rate of coinfection empirical use of antibacterial, antifungal, and antiviral treatment are advisable specifically at the early stage of COVID-19 infection. We also suggest running simultaneously diagnostic tests to identify other microbiological agents' coinfection with SARS-CoV-2.
背景
提供有关 SARS-CoV-2 合并感染病原体的信息可能对挽救患者生命有实际帮助。本研究旨在评估 COVID-19 患者合并感染病原体的流行率。
方法
为了查找所有相关文章,我们采用了系统搜索方法。研究型数据库包括 PubMed、Web of Science、Embase 和 Scopus,不限制语言,对 2019 年 12 月 1 日至 2021 年 8 月 23 日期间 COVID-19 病例中细菌、真菌和病毒合并感染的相关研究进行了检索。为了深入挖掘,还探查了其他科学存储库,如 Medrxiv。
结果
通过系统搜索共发现 13023 项研究。经过彻底分析,仅纳入 64 项研究(61547 例患者)。COVID-19 患者合并感染最常见的病原体是细菌(合并感染率:20.97%;95%CI:15.95-26.46;I²:99.9%),较少见的是病毒合并感染(合并感染率:12.58%;95%CI:7.31-18.96;I²:98.7%)。真菌合并感染的合并感染率也为 12.60%(95%CI:7.84-17.36;I²:98.3%)。Meta 回归分析显示,年龄、样本量和世卫组织地理区域并未影响异质性。
结论
我们发现 COVID-19 患者合并感染病原体的比例较高。鉴于这种合并感染率,建议在 COVID-19 感染的早期阶段,经验性使用抗菌、抗真菌和抗病毒治疗。我们还建议同时进行诊断检测,以确定与 SARS-CoV-2 合并感染的其他微生物病原体。