ArticleThe Journal of infectious diseases2025
Bacterial and Viral Coinfections in Adult Patients Hospitalized With COVID-19 Throughout the Pandemic: A Multinational Cohort Study in the EuCARE Project.
Article in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Viral Pathogen-Specific Severe Acute Respiratory Infections in Hospitalised Adults in Europe: Epidemiological Findings from the id.DRIVE Study 2024-2025.Infectious diseases and therapy · 2026Article
- Post-COVID Respiratory Sequelae in COPD: Mucus Plugging, Infectious Complications, and Risk-Stratified Follow-Up.Journal of clinical medicine · 2026Review
- Clinical characteristics of acute lower respiratory tract infection caused by Omicron, respiratory syncytial virus, and influenza virus a in children in Chengdu: a retrospective study.Italian journal of pediatrics · 2025Article
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Authors and funding
22 authors.
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Abstract
backgroundLimited evidence exists on how bacterial and viral coinfections have developed since the SARS-CoV-2 Omicron variant emerged. We investigated whether community-onset coinfections in adult patients hospitalized with COVID-19 differed during the wild type, Alpha, Delta, and Omicron periods and whether such coinfections were associated with an increased risk of mortality.
methodsWe conducted a multinational cohort study including COVID-19 hospitalizations until 30 April 2023 in 5 European countries. The outcome was bacterial and viral coinfections based on 5 test modalities. Variant periods were compared with regard to occurrences of coinfections and risk ratios for coinfections (Omicron vs pre-Omicron), as well as association with in-hospital mortality (Omicron vs pre-Omicron).
resultsA total of 29 564 cases were included: 12 601 wild type, 5256 Alpha, 2433 Delta, and 9274 Omicron. The coinfection rate was 2.6% (327/12 601) for wild type, 2.0% (105/5256) for Alpha, 3.2% (77/2433) for Delta, and 7.9% (737/9274) for Omicron. Omicron had a significantly increased risk ratio of coinfection when compared with preceding variants (1.88 [95% CI, 1.53-2.32], P < .001). These results were consistent across several subgroup analyses. An increased occurrence (19% [232/1246] vs 11% [3042/28 318]) and adjusted risk (1.69 [95% CI, 1.49-1.91], P < .001) of in-hospital mortality were observed in patients with a verified coinfection as compared with patients without a coinfection.
conclusionsBacterial and viral coinfections were more prevalent during the Omicron period as compared with preceding variants. Such coinfections were associated with an increased risk of in-hospital mortality, calling for sustained monitoring and clinical vigilance.
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