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COVID-19 Complications and Co-infections

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A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Coronaviruses".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 8825

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Special Issue Editors

Dr. Amir Sohail

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Guest Editor

School of Medicine, University of New Mexico, Albuquerque, NM, USA
Interests: COVID-19 complications; clinical outcomes with COVID-19 disease; systemic disorders

Dr. Abu Baker Sheikh

E-Mail Website
Guest Editor

Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87106, USA
Interests: COVID-19 infection; hospital medicine; COVID-19 complications
Special Issues, Collections and Topics in MDPI journals

Dr. Adeel Nasrullah

E-Mail Website
Guest Editor

West Penn Allegheny Health System, Pittsburgh, PA, USA
Interests: COVID-19; acute respiratory distress syndrome; asthma and COPD

Special Issue Information

Dear Colleagues,

Since the outbreak of the COVID-19 pandemic in 2019, our understanding of the disease has undergone rapid development. We have gained significant insights into COVID-19, including its risk factors, pathophysiology, clinical course, outcomes, complications, prognosis, associated co-morbid conditions and co-infections, as well as optimal treatment and management options. However, despite these advancements, there are still notable gaps in our knowledge, especially as new variants continue to evolve.

This Special Issue examines the short- and long-term clinical outcomes of COVID-19 disease and its associated co-infections. We especially welcome:

Virology research that presents original empirical studies (using qualitative, mixed, and quantitative methods), systematic reviews, short communications, case reports, and brief reports that contribute to our understanding of the course, outcomes, and prognosis of COVID-19;
Respiratory system complications associated with COVID-19 that include cardiovascular disease, thrombosis, kidney damage, neurological conditions, and gastrointestinal symptoms. These complications, together with co-infections such as bacterial pneumonia, influenza virus infection, and fungal infections, can increase the severity and complexity of the disease;
Critical perspectives and articles that examine how clinical and public health initiatives and interventions can effectively reduce morbidity, mortality, and the burden on healthcare systems caused by COVID-19, which are crucial. Understanding the nature of these complications and co-infections is important for informing strategies to effectively manage and treat COVID-19.

We aim to bridge existing knowledge gaps and advance our understanding of COVID-19 and its associated co-infections and complications. Global perspectives in submissions are welcomed.

Dr. Amir Sohail
Dr. Abu Baker Sheikh
Dr. Adeel Nasrullah
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Viruses is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

SARS-CoV-2
COVID-19
complications
co-infections
hospitalization

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Published Papers (8 papers)

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Research

7 pages, 214 KiB

Open AccessArticle

High Levels of Incidental COVID-19 Infection in Emergency Urology Admissions: A Propensity Score-Matched Real World Data Analysis across Surgical Specialties

by Alex Qinyang Liu, Eric Ka-Ho Choy, Peter Ka-Fung Chiu, Chi-Hang Yee, Chi-Fai Ng and Jeremy Yuen-Chun Teoh

Viruses 2024, 16(9), 1402; https://doi.org/10.3390/v16091402 - 31 Aug 2024

Viewed by 511

Abstract

Background: An incidental COVID-19 infection is often found in patients admitted for non-COVID-19-related conditions. This study aims to investigate the incidence of COVID-19 infections across surgical specialties including urology, general surgery, and orthopaedic surgery. Methods: This is a retrospective cohort study based on a territory-wide electronic database in Hong Kong. All emergency in-hospital admissions under the urology, general surgery, and orthopaedic surgery divisions in the public healthcare system in Hong Kong from January to September 2022 were included. All patients were routinely screened for SARS-CoV-2, based on admission protocols during the investigation period. Baseline characteristics were retrieved, with 1:1:1 propensity score matching being performed. Incidental COVID-19 rates were then compared across specialties. Results: A total of 126,034 patients were included. After propensity score matching, the baseline characteristics were well balanced, and 8535 patients in each group were analysed. Urology admission was noted to have a statistically significant higher incidence of incidental COVID-19 at 9.3%, compared to general surgery (5.4%) or orthopaedic surgery (5.6%). Amongst urology patients with incidental COVID-19 infection, 35.8% were admitted for retention of urine, 27.9% for haematuria, and 8.6% for a urinary tract infection. Conclusions: This large-scale cohort study demonstrated that incidental COVID-19 rates differ between surgical specialties, with urology having the highest proportion of incidental COVID-19 infection. Full article

(This article belongs to the Special Issue COVID-19 Complications and Co-infections)

9 pages, 213 KiB

Open AccessArticle

Outcomes of COVID-19 and Influenza in Cerebral Palsy Patients Hospitalized in the United States: Comparative Study of a Nationwide Database

by Mohammed A. Quazi, Muhammad Hassan Shakir, Zohaa Faiz, Ibrahim Quraishi, Adeel Nasrullah, Hafiz Abdullah Ikram, Amir H Sohail, Sulaiman Sultan and Abu Baker Sheikh

Viruses 2024, 16(8), 1284; https://doi.org/10.3390/v16081284 - 12 Aug 2024

Viewed by 1288

Abstract

Patients with cerebral palsy (CP) are particularly vulnerable to respiratory infections, yet comparative outcomes between COVID-19 and influenza in this population remain underexplored. Using the National Inpatient Sample from 2020–2021, we performed a retrospective analysis of hospital data for adults with CP diagnosed with either COVID-19 or influenza. The study aimed to compare the outcomes of these infections to provide insights into their impact on this vulnerable population. We assessed in-hospital mortality, complications, length of stay (LOS), hospitalization costs, and discharge dispositions. Multivariable logistic regression and propensity score matching were used to adjust for confounders, enhancing the analytical rigor of our study. The study cohort comprised 12,025 patients—10,560 with COVID-19 and 1465 with influenza. COVID-19 patients with CP had a higher in-hospital mortality rate (10.8% vs. 3.1%, p = 0.001), with an adjusted odds ratio of 3.2 (95% CI: 1.6–6.4). They also experienced an extended LOS by an average of 2.7 days. COVID-19 substantially increases the health burden for hospitalized CP patients compared to influenza, as evidenced by higher mortality rates, longer hospital stays, and increased costs. These findings highlight the urgent need for tailored strategies to effectively manage and reduce the impact of COVID-19 on this high-risk group. Full article

(This article belongs to the Special Issue COVID-19 Complications and Co-infections)

11 pages, 410 KiB

Open AccessArticle

Prevalence and Clinical Impact of Viral and Bacterial Coinfections in Hospitalized Children and Adolescents Aged under 18 Years with COVID-19 during the Omicron Wave in Russia

by Alexander S. Yakovlev, Vladislav V. Afanasev, Svetlana I. Alekseenko, Ilmira K. Belyaletdinova, Ludmila N. Isankina, Irina A. Gryaznova, Anatoly V. Skalny, Liubov I. Kozlovskaya, Aydar A. Ishmukhametov and Galina G. Karganova

Viruses 2024, 16(8), 1180; https://doi.org/10.3390/v16081180 - 23 Jul 2024

Viewed by 634

Abstract

The COVID-19 pandemic has altered respiratory infection patterns in pediatric populations. The emergence of the SARS-CoV-2 Omicron variant and relaxation of public health measures have increased the likelihood of coinfections. Previous studies show conflicting results regarding the impact of viral and bacterial coinfections with SARS-CoV-2 on severity of pediatric disease. This study investigated the prevalence and clinical impact of coinfections among children hospitalized with COVID-19 during the Omicron wave. A retrospective analysis was conducted on 574 hospitalized patients aged under 18 years in Russia, from January 2022 to March 2023. Samples from patients were tested for SARS-CoV-2 and other respiratory pathogens using qRT-PCR, bacterial culture tests and mass spectrometry, and ELISA. Approximately one-third of COVID-19 cases had coinfections, with viral and bacterial coinfections occurring at similar rates. Adenovirus and Staphylococcus aureus were the most common viral and bacterial coinfections, respectively. Viral coinfections were associated with higher fevers and increased bronchitis, while bacterial coinfections correlated with longer duration of illness and higher pneumonia rates. Non-SARS-CoV-2 respiratory viruses were linked to more severe lower respiratory tract complications than SARS-CoV-2 monoinfection. These findings suggest that during the Omicron wave, seasonal respiratory viruses may have posed a greater threat to children’s health than SARS-CoV-2. Full article

(This article belongs to the Special Issue COVID-19 Complications and Co-infections)

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9 pages, 1266 KiB

Open AccessArticle

Burden of COVID-19 in the Pediatric Population at Hospital Central de Maputo, Mozambique, October 2020 to October 2022

by Adilson Fernando Loforte Bauhofer, Emerson Miranda, Édio Ussivane, Assucênio Chissaque, Luciana António, Fernanda Campos, Ramígio Pololo, Fátima Iahaia, Aline Gatambire, Fátima Ráice, Marlene Djedje, Judite Salência, Plácida Maholela, Luzia Gonçalves, Osvaldo Inlamea and Nilsa de Deus

Viruses 2024, 16(7), 1112; https://doi.org/10.3390/v16071112 - 11 Jul 2024

Viewed by 672

Abstract

The epidemiology and characteristics of SARS-CoV-2 in the hospitalized Mozambican pediatric population are scarce. We aimed to assess the burden of COVID-19 in the pediatric population at Hospital Central de Maputo and identify comorbidities and factors associated with death among hospitalized COVID-19 cases. A cross-sectional study was conducted from October 2020 to October 2022. Available records were retrieved from admission books. Univariate and bivariate analyses were reported to describe the sample characteristics. The frequency of pediatric cases admitted with COVID-19 was 0.6% (95% confidence interval (CI): 0.5–0.6; 364/63,753), and the frequency of pediatric cases hospitalized with COVID-19 was 2.5% (95% CI: 2.2–2.9; 173/6807). The monthly frequency of pediatric cases admitted and hospitalized with COVID-19 ranged from 0.1% to 5.4% and from 0.2% to 42.1%, respectively. In children hospitalized with COVID-19, underweight was the most observed comorbidity (17.4%; 19/109); death was observed in 30% (95% CI: 22.2–39.1; 33/110), and it was significantly higher in underweight children than in non-underweight children (61.5% [8/13] vs. 21.3% [16/75]; p-value = 0.005). Given the heightened risk of mortality among undernourished children compared to non-undernourished children, vaccination for COVID-19 should be prioritized for undernourished children. Full article

(This article belongs to the Special Issue COVID-19 Complications and Co-infections)

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0 pages, 1049 KiB

Open AccessArticle

High Serum S100A12 as a Diagnostic and Prognostic Biomarker for Severity, Multidrug-Resistant Bacteria Superinfection and Herpes Simplex Virus Reactivation in COVID-19

by Patricia Mester, Dennis Keller, Claudia Kunst, Ulrich Räth, Sophia Rusch, Stephan Schmid, Sabrina Krautbauer, Martina Müller, Christa Buechler and Vlad Pavel

Viruses 2024, 16(7), 1084; https://doi.org/10.3390/v16071084 - 5 Jul 2024

Viewed by 873

Abstract

Neutrophils are critical immune cells in severe coronavirus disease 2019 (COVID-19). S100 calcium-binding protein A12 (S100A12) is highly expressed in neutrophils during acute inflammation. The aim of this study was to evaluate serum S100A12 levels as a diagnostic and prognostic tool in COVID-19. Serum samples of patients with moderate and severe COVID-19 were collected during 2020 to 2024. Enzyme-linked immunosorbent assay was used to measure serum S100A12 levels in 63 patients with moderate COVID-19, 60 patients with severe disease and 33 healthy controls. Serum S100A12 levels were elevated in moderate COVID-19 compared to controls and were even higher in severe cases. In moderate disease, serum S100A12 levels positively correlated with immune cell counts. While C-reactive protein and procalcitonin are established inflammation markers, they did not correlate with serum S100A12 levels in either patient cohort. Patients with severe COVID-19 and vancomycin-resistant enterococcus (VRE) infection had increased S100A12 levels. Elevated S100A12 levels were also observed in patients with herpes simplex reactivation. Fungal superinfections did not alter S100A12 levels. These data show that serum S100A12 increases in moderate and severe COVID-19 and is further elevated by VRE bloodstream infection and herpes simplex reactivation. Therefore, S100A12 may serve as a novel biomarker for severe COVID-19 and an early diagnostic indicator for bacterial and viral infections. Full article

(This article belongs to the Special Issue COVID-19 Complications and Co-infections)

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14 pages, 677 KiB

Open AccessArticle

Severe COVID-19 Outcomes in Five Latin American Countries in the Postvaccination Era

by Guilherme Silva Julian, Júlia Spinardi, Melissa Diaz-Puentes, Diana Buitrago, Ida Caterina García and Moe H. Kyaw

Viruses 2024, 16(7), 1025; https://doi.org/10.3390/v16071025 - 26 Jun 2024

Viewed by 1257

Abstract

We conducted a multicountry retrospective study using data from COVID-19 national surveillance databases to analyze clinical profiles, hospitalization rates, intensive care unit (ICU) admissions, utilization of ventilatory support, and mortality rates in five Latin American countries in the context of COVID-19 vaccination implementation. We analyzed the sociodemographic characteristics, comorbidities, clinical outcomes, and vaccination status of laboratory-confirmed COVID-19 cases from January 2021 to December 2022. We calculated the yearly and quarterly hospitalization rates per 1000 confirmed COVID-19 cases and ICU admissions, use of mechanical ventilators, and mortality rates per 1000 hospitalized cases, with their corresponding 95% confidence interval (CI) of 38,852,831 confirmed COVID-19 cases. Rates of hospitalization, ICU admission, ventilatory support, and death were higher among males than among females (38.2 vs. 32.4, 148.4 vs. 117.7, 282.9 vs. 236.2, and 346.9 vs. 320.1 per 1000, respectively); higher in 2021 than in 2022 (50.7 vs. 19.9, 207.8 vs. 58.2, 441.5 vs. 114.9, and 352.5 vs. 285.2 per 1000, respectively); and in the >50 age group (range: 5.7–18.6, 20.1–71.5, 12.2–67.9, and 353.1–577.4, per 1000) than the <50 age group (range: 2.2–9.3, 5.4–33.2, 41.4–135.8, and 22–243.5 per 1000). Hypertension and diabetes mellitus were the most common comorbidities in Mexico and Colombia. Prevention and treatment strategies for these case profiles could bring benefits from a public health perspective. Full article

(This article belongs to the Special Issue COVID-19 Complications and Co-infections)

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14 pages, 877 KiB

Open AccessArticle

Neurological Manifestations of Acute SARS-CoV-2 Infection in Pediatric Patients: A 3-Year Study on Differences between Pandemic Waves

by Iolanda Cristina Vivisenco, Andreea Lescaie, Ana Dragomirescu, Ioana Cătălina Ioniță, Irina Florescu, Bogdan Ciocea, Andreea Rodica Grama, Maria-Dorina Crăciun, Carmen-Daniela Chivu, Coriolan Emil Ulmeanu and Viorela Gabriela Nițescu

Viruses 2024, 16(6), 967; https://doi.org/10.3390/v16060967 - 17 Jun 2024

Viewed by 2080

Abstract

This study analyzed the neurological manifestation profiles of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across pandemic waves in pediatric patients. The study collected data on patients aged between 0 and 18 years, diagnosed with acute SARS-CoV-2 infection, admitted to a pediatric tertiary hospital between 1 March 2020 and 28 February 2023. This study included 1677 patients. Neurological manifestations were noted in 10% (n = 168) of patients with a median age of 3.2 years (interquartile range: 1–11.92). Neurological manifestations were significantly associated with the pandemic waves (p = 0.006) and age groups (p < 0.001). Seizures were noted in 4.2% of cases and reached an increasing frequency over time (p = 0.001), but were not associated with age groups. Febrile seizures accounted for the majority of seizures. Headache was reported in 2.6% of cases and had similar frequencies across the pandemic waves and age groups. Muscular involvement was noted in 2% of cases, reached a decreasing frequency over time (p < 0.001), and showed different frequencies among the age groups. Neurological manifestations of acute SARS-CoV-2 infection exhibit distinct patterns, depending on the pandemic wave and patient age group. The Wuhan and Omicron waves involved the nervous system more often than the other waves. Full article

(This article belongs to the Special Issue COVID-19 Complications and Co-infections)

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12 pages, 1604 KiB

Open AccessArticle

The Impact of COVID-19 during Pregnancy on Maternal Hemodynamic Function, Angiogenic Markers and Neonatal Outcome

by Nawa Schirwani-Hartl, Lena Tschanun, Pilar Palmrich, Christina Haberl, Nicole Perkmann-Nagele, Herbert Kiss, Angelika Berger and Julia Binder

Viruses 2024, 16(6), 868; https://doi.org/10.3390/v16060868 - 29 May 2024

Viewed by 793

Abstract

Infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) in pregnancy are associated with the development of preeclampsia and fetal growth restriction (FGR). Recently, preeclampsia was linked to impaired maternal hemodynamic function. This retrospective study evaluated singleton pregnancies with COVID-19 during pregnancy and healthy pregnant controls matched for gestational age from November 2020 to March 2022. Non-invasive assessment of maternal hemodynamics by continuous wave Doppler ultrasound measurements (USCOM-1A^® Monitor) and oscillometric arterial stiffness (Arteriograph) was performed. Overall, 69 pregnant women were included—23 women after COVID-19 during pregnancy and 46 healthy controls. While two women (8.7%) were admitted to the hospital due to COVID-19-related symptoms, none required intensive care unit admission or non-invasive/invasive ventilation. There were no statistically significant differences in the majority of hemodynamic parameters between the two cohorts. The prevalence of FGR was significantly higher in the COVID-19 during pregnancy group (9.5% vs. healthy controls: 0.0%; p = 0.036), especially in nulliparous women. No difference in angiogenic markers and neonatal outcomes were observed between pregnant women after COVID-19 and healthy controls. In conclusion, no significant differences in hemodynamic parameters or neonatal outcome were observed in women with COVID-19 during pregnancy. However, an increased prevalence of FGR could be described. Full article

(This article belongs to the Special Issue COVID-19 Complications and Co-infections)

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