• Coinfections in SARS-CoV-2 pateints with other Respiratory viruses
  • Seyed Amir Mohammad Seyed Mirzajani,1 Seyed Reza Mohebbi,2,* Seyed Masoud Hosseini,3 Piruz Shadbash,4 Mahsa Saeedi Niasar,5 Hamid Asadzadeh-Aghdaei,6
    1. Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences
    2. Research Center for Gastroenterology and Liver Diseases, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    3. Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
    4. Department of Microbiology and Microbial Biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
    5. Research Center for Gastroenterology and Liver Diseases, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    6. Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran


  • Introduction: In December 2019, a series of unknown viral pneumonia cases later named coronavirus disease 2019 (COVID-19) or SARS-CoV-2 was reported in Wuhan, China. The virus spread rapidly beyond Wuhan, affecting numerous nations, regions, and territories worldwide and infecting over 219 million people to date (24 September 2021). As a result, COVID-19 has become a worldwide concern and a public health issue. Coronavirus is transmitted mostly by respiratory droplets spread into the air after coughing or sneezing. Coronavirus usually leads to fever, tiredness, dry cough, myalgia, and shortness of breath but the disease has a large variety of symptoms that make it difficult to diagnose accurately. Symptoms such as runny nose, sore throat, diarrhea, headache, conjunctivitis, loss of taste or smell, dizziness, loss of appetite, and nausea have also been reported in some patients. Organ failures, such as acute respiratory distress syndrome and even death, may be likely in severe cases.
  • Methods: Coinfection rates between SARS-CoV-2 and other respiratory viruses have been reported in some studies. Co-infection with SARS-CoV-2 and other respiratory viruses has been observed in several reports from the United States, China, and Iran. Influenza virus, respiratory syncytial virus, metapneumovirus, adenovirus, parainfluenza virus, rhinovirus/enterovirus, human bocavirus, and non-SARS-CoV-2 coronavirus are those which have been seen in these reports.
  • Results: Coinfections with Respiratory viruses in COVID-19 patients are often demonstrated and may lead to higher morbidity and death rates. During a SARS-CoV-2 infection, the pulmonary structure is significantly damaged, similar to influenza virus pneumonia. The assault of virus in alveolar epithelium and bronchial mucosa, the destruction of the epithelium, and enormous effusion in the bronchiole lumens of the infected individuals have all been reported in autopsy studies. These pathologic results might explain why COVID-19 patients are more likely to get infected with common respiratory infections, as some previous clinical trials and postmortem reports have shown. According to the findings of investigations done on co-infected individuals with COVID-19 and other respiratory viruses, several clinical and laboratory findings were similar in both illnesses, that makes it challenging to diagnose these co-infected patients properly.
  • Conclusion: Differentiating other causes of respiratory disease from COVID-19 during a COVID-19 pandemic is difficult since COVID-19's clinical signs are similar to those of other respiratory viruses. It shows that monitoring for co-infection with different types of respiratory viruses in patients with certain conditions should be properly considered to choose the right treatment strategies and effective management for COVID-19 patients. SARS-CoV-2 may also be underdiagnosed due to false-negative results for co-infection with other viral respiratory diseases, according to some studies. To enhance clinical management decisions and results, it is proposed that wider viral evaluations be done.
  • Keywords: SARS-CoV 2, Co-infection, COVID-19, Coronavirus, Respiratory viruses