Viral Coinfections in Hospitalized Coronavirus Disease 2019 Patients Recruited to the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK Study

ISARIC4C Investigators; Elen Vink; Chris Davis; Alasdair MacLean; David Pascall; Sarah E. McDonald; Rory Gunson; Hayley E. Hardwick; Wilna Oosthuyzen; Peter J M Openshaw; J Kenneth  Baillie; Malcolm G Semple; Antonia Ho

doi:10.1093/ofid/ofac531

Viral Coinfections in Hospitalized Coronavirus Disease 2019 Patients Recruited to the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK Study

ISARIC4C Investigators, Elen Vink, Chris Davis, Alasdair MacLean, David Pascall, Sarah E. McDonald, Rory Gunson, Hayley E. Hardwick, Wilna Oosthuyzen, Peter J M Openshaw, J Kenneth Baillie, Malcolm G Semple, Antonia Ho^*

^*Corresponding author for this work

Chemical Engineering

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Abstract

Background: We conducted this study to assess the prevalence of viral coinfection in a well characterized cohort of hospitalized coronavirus disease 2019 (COVID-19) patients and to investigate the impact of coinfection on disease severity.

Methods: Multiplex real-time polymerase chain reaction testing for endemic respiratory viruses was performed on upper respiratory tract samples from 1002 patients with COVID-19, aged <1 year to 102 years old, recruited to the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK study. Comprehensive demographic, clinical, and outcome data were collected prospectively up to 28 days post discharge.

Results: A coinfecting virus was detected in 20 (2.0%) participants. Multivariable analysis revealed no significant risk factors for coinfection, although this may be due to rarity of coinfection. Likewise, ordinal logistic regression analysis did not demonstrate a significant association between coinfection and increased disease severity.

Conclusions: Viral coinfection was rare among hospitalized COVID-19 patients in the United Kingdom during the first 18 months of the pandemic. With unbiased prospective sampling, we found no evidence of an association between viral coinfection and disease severity. Public health interventions disrupted normal seasonal transmission of respiratory viruses; relaxation of these measures mean it will be important to monitor the prevalence and impact of respiratory viral coinfections going forward.

Original language	English
Article number	ofac531
Number of pages	10
Journal	Open Forum Infectious Diseases
Volume	9
Issue number	11
Early online date	10 Oct 2022
DOIs	https://doi.org/10.1093/ofid/ofac531
Publication status	Published - Nov 2022

Bibliographical note

Financial support:
This work is supported by grants from the National Institute for Health Research (NIHR) (Award CO-CIN-01), the Medical Research Council (Grants MC_PC_19059 and MC_ST_CVR_2019), the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emerging and Zoonotic Infections at University of Liverpool (NIHR award 200907) and NIHR HPRU in Respiratory Infections at Imperial College London both in partnership with Public Health England (PHE)—now UK Health Security Agency (NIHR Award 200927), EU Platform for European Preparedness Against (Re-)emerging Epidemics, Wellcome Trust, and Department for International Development (215091/Z/18/Z), and the Bill and Melinda Gates Foundation (OPP1209135). Liverpool Experimental Cancer Medicine Centre provided infrastructure support for this research (Grant Reference: C18616/A25153).

Keywords

disease severity
PCR
respiratory virus
rhinovirus
SARS-CoV-2
surveillance

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ISARIC4C Investigators, Vink, E., Davis, C., MacLean, A., Pascall, D., McDonald, S. E., Gunson, R., Hardwick, H. E., Oosthuyzen, W., Openshaw, P. J. M., Baillie, J. K., Semple, M. G., & Ho, A. (2022). Viral Coinfections in Hospitalized Coronavirus Disease 2019 Patients Recruited to the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK Study. Open Forum Infectious Diseases, 9(11), Article ofac531. https://doi.org/10.1093/ofid/ofac531

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title = "Viral Coinfections in Hospitalized Coronavirus Disease 2019 Patients Recruited to the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK Study",

abstract = "Background: We conducted this study to assess the prevalence of viral coinfection in a well characterized cohort of hospitalized coronavirus disease 2019 (COVID-19) patients and to investigate the impact of coinfection on disease severity.Methods: Multiplex real-time polymerase chain reaction testing for endemic respiratory viruses was performed on upper respiratory tract samples from 1002 patients with COVID-19, aged <1 year to 102 years old, recruited to the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK study. Comprehensive demographic, clinical, and outcome data were collected prospectively up to 28 days post discharge.Results: A coinfecting virus was detected in 20 (2.0%) participants. Multivariable analysis revealed no significant risk factors for coinfection, although this may be due to rarity of coinfection. Likewise, ordinal logistic regression analysis did not demonstrate a significant association between coinfection and increased disease severity.Conclusions: Viral coinfection was rare among hospitalized COVID-19 patients in the United Kingdom during the first 18 months of the pandemic. With unbiased prospective sampling, we found no evidence of an association between viral coinfection and disease severity. Public health interventions disrupted normal seasonal transmission of respiratory viruses; relaxation of these measures mean it will be important to monitor the prevalence and impact of respiratory viral coinfections going forward.",

keywords = "disease severity, PCR, respiratory virus, rhinovirus, SARS-CoV-2, surveillance",

author = "{ISARIC4C Investigators} and Elen Vink and Chris Davis and Alasdair MacLean and David Pascall and McDonald, {Sarah E.} and Rory Gunson and Hardwick, {Hayley E.} and Wilna Oosthuyzen and Openshaw, {Peter J M} and Baillie, {J Kenneth} and Semple, {Malcolm G} and Antonia Ho and Christopher Green",

note = "Financial support: This work is supported by grants from the National Institute for Health Research (NIHR) (Award CO-CIN-01), the Medical Research Council (Grants MC_PC_19059 and MC_ST_CVR_2019), the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emerging and Zoonotic Infections at University of Liverpool (NIHR award 200907) and NIHR HPRU in Respiratory Infections at Imperial College London both in partnership with Public Health England (PHE)—now UK Health Security Agency (NIHR Award 200927), EU Platform for European Preparedness Against (Re-)emerging Epidemics, Wellcome Trust, and Department for International Development (215091/Z/18/Z), and the Bill and Melinda Gates Foundation (OPP1209135). Liverpool Experimental Cancer Medicine Centre provided infrastructure support for this research (Grant Reference: C18616/A25153). ",

year = "2022",

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ISARIC4C Investigators, Vink, E, Davis, C, MacLean, A, Pascall, D, McDonald, SE, Gunson, R, Hardwick, HE, Oosthuyzen, W, Openshaw, PJM, Baillie, JK, Semple, MG & Ho, A 2022, 'Viral Coinfections in Hospitalized Coronavirus Disease 2019 Patients Recruited to the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK Study', Open Forum Infectious Diseases, vol. 9, no. 11, ofac531. https://doi.org/10.1093/ofid/ofac531

Viral Coinfections in Hospitalized Coronavirus Disease 2019 Patients Recruited to the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK Study. / ISARIC4C Investigators; Vink, Elen; Davis, Chris et al.
In: Open Forum Infectious Diseases, Vol. 9, No. 11, ofac531, 11.2022.

Research output: Contribution to journal › Article › peer-review

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AU - ISARIC4C Investigators

AU - Vink, Elen

AU - Davis, Chris

AU - MacLean, Alasdair

AU - Pascall, David

AU - McDonald, Sarah E.

AU - Gunson, Rory

AU - Hardwick, Hayley E.

AU - Oosthuyzen, Wilna

AU - Openshaw, Peter J M

AU - Baillie, J Kenneth

AU - Semple, Malcolm G

AU - Ho, Antonia

AU - Green, Christopher

N1 - Financial support: This work is supported by grants from the National Institute for Health Research (NIHR) (Award CO-CIN-01), the Medical Research Council (Grants MC_PC_19059 and MC_ST_CVR_2019), the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emerging and Zoonotic Infections at University of Liverpool (NIHR award 200907) and NIHR HPRU in Respiratory Infections at Imperial College London both in partnership with Public Health England (PHE)—now UK Health Security Agency (NIHR Award 200927), EU Platform for European Preparedness Against (Re-)emerging Epidemics, Wellcome Trust, and Department for International Development (215091/Z/18/Z), and the Bill and Melinda Gates Foundation (OPP1209135). Liverpool Experimental Cancer Medicine Centre provided infrastructure support for this research (Grant Reference: C18616/A25153).

PY - 2022/11

Y1 - 2022/11

N2 - Background: We conducted this study to assess the prevalence of viral coinfection in a well characterized cohort of hospitalized coronavirus disease 2019 (COVID-19) patients and to investigate the impact of coinfection on disease severity.Methods: Multiplex real-time polymerase chain reaction testing for endemic respiratory viruses was performed on upper respiratory tract samples from 1002 patients with COVID-19, aged <1 year to 102 years old, recruited to the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK study. Comprehensive demographic, clinical, and outcome data were collected prospectively up to 28 days post discharge.Results: A coinfecting virus was detected in 20 (2.0%) participants. Multivariable analysis revealed no significant risk factors for coinfection, although this may be due to rarity of coinfection. Likewise, ordinal logistic regression analysis did not demonstrate a significant association between coinfection and increased disease severity.Conclusions: Viral coinfection was rare among hospitalized COVID-19 patients in the United Kingdom during the first 18 months of the pandemic. With unbiased prospective sampling, we found no evidence of an association between viral coinfection and disease severity. Public health interventions disrupted normal seasonal transmission of respiratory viruses; relaxation of these measures mean it will be important to monitor the prevalence and impact of respiratory viral coinfections going forward.

AB - Background: We conducted this study to assess the prevalence of viral coinfection in a well characterized cohort of hospitalized coronavirus disease 2019 (COVID-19) patients and to investigate the impact of coinfection on disease severity.Methods: Multiplex real-time polymerase chain reaction testing for endemic respiratory viruses was performed on upper respiratory tract samples from 1002 patients with COVID-19, aged <1 year to 102 years old, recruited to the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK study. Comprehensive demographic, clinical, and outcome data were collected prospectively up to 28 days post discharge.Results: A coinfecting virus was detected in 20 (2.0%) participants. Multivariable analysis revealed no significant risk factors for coinfection, although this may be due to rarity of coinfection. Likewise, ordinal logistic regression analysis did not demonstrate a significant association between coinfection and increased disease severity.Conclusions: Viral coinfection was rare among hospitalized COVID-19 patients in the United Kingdom during the first 18 months of the pandemic. With unbiased prospective sampling, we found no evidence of an association between viral coinfection and disease severity. Public health interventions disrupted normal seasonal transmission of respiratory viruses; relaxation of these measures mean it will be important to monitor the prevalence and impact of respiratory viral coinfections going forward.

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KW - PCR

KW - respiratory virus

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KW - SARS-CoV-2

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ISARIC4C Investigators, Vink E, Davis C, MacLean A, Pascall D, McDonald SE et al. Viral Coinfections in Hospitalized Coronavirus Disease 2019 Patients Recruited to the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK Study. Open Forum Infectious Diseases. 2022 Nov;9(11):ofac531. Epub 2022 Oct 10. doi: 10.1093/ofid/ofac531