Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Invasive Pneumococcal Disease and Risk of Pneumococcal Coinfection With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): Prospective National Cohort Study, England

被引：76
作者：
Amin-Chowdhury, Zahin [1 ]
Aiano, Felicity [1 ]
Mensah, Anna [1 ]
Sheppard, Carmen L. [2 ]
Litt, David [2 ]
Fry, Norman K. [1 ,2 ]
Andrews, Nick [3 ]
Ramsay, Mary E. [1 ,4 ]
Ladhani, Shamez N. [1 ,5 ]
机构：
[1] Publ Hlth England, Immunisat & Countermeasures Div, 61 Colindale Ave, London NW9 5EQ, England
[2] Publ Hlth England, Resp & Vaccine Preventable Bacterial Reference Un, London, England
[3] Publ Hlth England, Stat Modelling & Econ Dept, London, England
[4] London Sch Hyg & Trop Med, London, England
[5] St Georges Univ London, Paediat Infect Dis Res Grp PIDRG, London, England
来源：
CLINICAL INFECTIOUS DISEASES | 2021年 / 72卷 / 05期
关键词：
pneumococcal disease; bacterial coinfection; nosocomial infection; case fatality; risk factor; INFLUENZA; VACCINE; WALES; SEROTYPES; INCREASE;
D O I：
10.1093/cid/ciaa1728
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
Background. Streptococcus pneumoniae coinfection with influenza results in synergistic lethality, but there are limited data on pneumococcal coinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods. Public Health England conducts invasive pneumococcal disease (IPD) and SARS-CoV-2 surveillance in England. IPD trends during 2000/2001-2019/2020 epidemiological years were analyzed and cases during February-June 2020 linked with laboratory-confirmed SARS-CoV-2 infections. Multivariable logistic regression was used to assess risk factors for death. Results. IPD incidence in 2019/2020 (7.6/100 000; n = 3964) was 30% (IRR, .70; 95% CI, .18-2.67) lower compared with 2018/2019 (10.9/100 000; n = 5666), with large reductions observed across all age groups during March-June 2020. There were 160 886 SARS-CoV-2 and 1137 IPD cases during February-June 2020, including 40 IPD/coronavirus disease 2019 (COVID-19) co-infections (.025% [95% CI, .018-.034] of SARS-CoV-2 infections; 3.5% [2.5-4.8] of IPD cases), 21 with COVID-19 diagnosed 3-27 days after IPD, and 27 who developed COVID-19 >28 days after IPD. Case-fatality rates (CFRs) were 62.5 (25/40), 47.6% (10/21), and 33.3% (9/27), respectively (P < .001). In addition to an independent association with increasing age and serotype group, CFR was 7.8-fold (95% CI, 3.8-15.8) higher in those with IPD/COVID-19 coinfection and 3.9-fold (95% CI, 1.4-10.7) higher in patients who developed COVID-19 3-27 days after IPD compared with patients with IPD only. Conclusions. Large declines in IPD were observed following COVID-19 lockdown. IPD/COVID-19 coinfections were rare but associated with high CFR, mainly in older adults. The rarity, age and serotype distribution of IPD/COVID-19 coinfections do not support wider extension of pneumococcal vaccination.
引用
收藏
页码：E65 / E75
页数：11
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