bacterial and fungal coinfections among patients with covid-19 in zanjan, northwest of iran; a single-center observational with meta-analysis of the literature

Background and objectives: there is a poor understanding about the prevalence and characteristics of secondary bacterial and fungal infections among coronavirus diseases 2019 (covid-19) superinfection in hospitalized patients. materials and methods: four hundred covid-19-proven patients were enrolled in this study. nasal swabs for molecular assay (real-time pcr) and sputum samples for further microbiological assays were collected. following a broad-spectrum search, a meta-analysis was performed using statsdirect software (version 2.7.9) according to the dersimonian and laird method applying the random-effects models. results: streptococcus spp. (21.5%) and staphylococcus spp. (16.7%) had the highest prevalence of bacterial coinfection among the covid-19 patients, while acinetobacter spp. had the lowest prevalence (4.2%). among fungal coinfections, candida albicans was the most prevalent (6.7%), and aspergillus spp. was the lowest (2%). males, elderly patients, patients with a history of underlying diseases and drug use, patients who showed acute clinical symptoms, and patients with a pro- longed hospital stay had a higher incidence of secondary infections (p-value <0.05). the pooled prevalence for bacterial and fungal coinfections was 33.52% (95% ci: 18.12 to 50.98; i2: 99.4%; p-value: <0.0001). conclusion: we suggest designing additional research with a larger target population and diagnostic molecular analyses to depict a more realistic view of the coinfection status.