Bacterial Co-infection among COVID-19 patient groups: an update Systematic review and Meta-analysis

Soltani, Saber; Faramarzi, Samireh; Zandi, Milad; Shahbahrami, Ramin; Jafarpour, Ali; Rezayat, Sara Akhavan; Pakzad, Iraj; Abdi, Fatemeh; Malekifar, Pooneh; Pakzad, Reza

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.