Coinfections in Covid-19 patients in India: A Systematic Review

Abstract Objectives To determine the rate of coinfections and its subsequent impact on hospitalization and mortality rate in Indian COVID-19 patients. Method Systematic literature search was performed on PubMed, Cochrane, WHO-COVID-19 database, and Google Scholar. The studies were retrieved and included based on JBI’s CoCoPop framework. Meta-analysis was not performed due to limited number of studies and high heterogeneity. Hence, descriptive statistics was summarized based on the retrieved coinfections data. The protocol was registered with PROSPERO – CRD42021275644. Results Eight studies included 2418 patients. The prevalence of coinfections ranged from 4%-46%. Pathogen-specific data showed the highest prevalence of bacterial (57.3%) coinfections, followed by parasitic (21.1.%), viral (14.6%), and fungal coinfection (6.9%). About 60–80% of the patients with coinfections required ICU admissions with an average length of stay of 13.67 ± 3.51 days. The mortality rate of COVID-19 patients with coinfections ranged from 9%-65%. Conclusion The prevalence of bacterial coinfections was highest among COVID-19 patients, consistent with previous literature. A causal relationship between coinfections and mortality rate in COVID-19 patients remained unexplored. This brings up the need for comprehensive data recording practices and meticulous reporting. Further, large-scale epidemiologic studies are needed to determine the nationwide burden of coinfections in the COVID-19 pandemic.