TY - JOUR
T1 - 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)
T2 - Prospective National Cohort Study, England
AU - Amin-Chowdhury, Zahin
AU - Aiano, Felicity
AU - Mensah, Anna
AU - Sheppard, Carmen L.
AU - Litt, David
AU - Fry, Norman
AU - Andrews, Nicholas
AU - Ramsay, Mary
AU - Ladhani, Shamez
N1 - Publisher Copyright:
© 2020 Crown copyright 2020.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - 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.
AB - 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.
KW - bacterial coinfection
KW - case fatality
KW - nosocomial infection
KW - pneumococcal disease
KW - risk factor
UR - http://www.scopus.com/inward/record.url?scp=85102239148&partnerID=8YFLogxK
U2 - 10.1093/cid/ciaa1728
DO - 10.1093/cid/ciaa1728
M3 - Article
C2 - 33196783
AN - SCOPUS:85102239148
VL - 72
SP - E65-E75
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 5
ER -
