ASSOCIATION OF SEVERITY OF COVID-19 WITH CO-INFECTIONS WITH INFLUENZAAND OTHER RESPIRATORY VIRUSES

Objectives: Co-infections with viral, bacterial, and fungal pathogens have been reported in Corona virus disease 2019 (COVID-19) patients. A new concern is presence of co-infections with other respiratory viruses, which could complicate diagnosis, treatment, and disease outcomes. This study aimed to detect Inuenza and other respiratory viruses in COVID-19 patients and assess the association between co-infections and severity of COVID-19. Materials And Methods: A nested case-control study was conducted with 760 real-time polymerase chain reaction (RT-PCR) positive COVID-19 patients of all ages and sexes, enrolled over two consecutive years (January-March 2021 and 2022). Nasopharyngeal or oropharyngeal swabs were tested for 13 respiratory viruses using polymerase chain reaction (PCR). Association of co-infection with respiratory viruses and severity of illness was calculated. Statistical Analysis: The chi-square test was used to analyze the relationship between respiratory virus positivity and disease severity/mortality. Data analysis was performed using Statistical Package for Social Sciences (SPSS) Version 21.0. Results: Co-infections with other respiratory viruses were observed in 87 (11.44%) of the 760 COVID-19 patients. The majority of co-infections were with Inuenza A (42, 5.53%), followed by Parainuenza virus 3 (12, 1.58%) and Rhinovirus (10, 1.32%). No co-infections were observed with Respiratory Syncytial Virus (RSV) Aand B, Parainuenza 2, and Bocavirus. Co-infections were most common in patients aged 60-80 years. Signicant association between co-infection and severity of disease was observed in patients having co-infection with Inuenza virus. Poor outcome was also associated with advanced age, patients with one or more comorbidities and patients who required Intensive Care Unit (ICU) admission. Conclusion: Increased severity, mortality and higher rates of hospitalisation was seen in COVID-19 patients having co-infection with Inuenza viruses.