Coinfections
In the study, 14 cases of coinfections were identified, equivalent to
13.6% of the total samples analysed. The most detected viruses were
HCoV-229E and HRSV, adding up to 57.1% of the total co-infections.
Besides HCoV 229E, another coronavirus was detected, HCoV-OC43, which
belongs to the same genus as SARS-CoV-2. The rest of the cases involved
HRV, Inf A, HPIV1, HPIV2, and HPIV4 ( Fig. 1).
In general, the coinfected patients presented a milder picture of
respiratory infection, 13 (92.9%) of them corresponding to outpatient
cases. Only the case of coinfection involving Inf A required
hospitalization and resulted in the death of the patient.
The symptoms presented by the coinfected patients are shown in Table 3.
No significant differences were found between the initial symptoms of
these patients and the symptoms of those infected only with SARS-CoV-2,
with the exception of diarrhoea. There were also no differences in the
number of symptoms between the two groups. It is worth mentioning that
the most severe symptoms, such as dyspnoea and the few cases of
cyanosis, occurred almost exclusively in patients infected only with
SARS-CoV-2.
To verify whether the coinfected patients presented milder cases of the
disease due to a better general health status, we compared the
single-infected and coinfected groups on age, several comorbidities, and
immune status. The comorbidities evaluated were diabetes, hypertension,
chronic kidney disease, chronic liver disease, COPD, asthma, obesity,
and haemolytic anaemia. The statistical analyses did not reveal
significant differences in the frequency of any of these comorbidities
between the two groups (P>0.05) ( Table 4).
Next, to verify whether coinfection with other respiratory viruses
positively or negatively affected the viral load of SARS-CoV-2, absolute
quantification was performed by RT-qPCR in all the samples included in
the study. Although the P-value was not significant
(P>0.05), the mean viral load was lower in the cases of
coinfection (676,220 ± 749,715 vs 2,353,580 ± 1,283,262) (Fig. 2). Both
the viral load, as well as the age and comorbidities of each coinfected
patient can be seen in Table 5.