key: cord-0052878-f25t0kdg
authors: Reina, Jordi; Suarez, Loreto; Lara, Paula
title: Detection of respiratory viruses in patients with suspected SARS-CoV-2 infection()
date: 2020-11-19
journal: nan
DOI: 10.1016/j.eimce.2020.11.005
sha: 481f5a7b86de139d2824f2cf121faf30ea3efac9
doc_id: 52878
cord_uid: f25t0kdg

nan

There are few studies on the detection of other respiratory viruses in patients with suspected COVID-19. In a study by Bordi et al. 4 

CoV-2 were detected (2.4%) versus the 48 (26.2%) in our study. This was because the Italian study was conducted at the start of the pandemic, with a low incidence of infection caused by the novel coronavirus. This data is corroborated by the fact that said study detected influenza viruses in 28.5% of its patients, while our study only detected 11 cases of influenza (6%), probably because our study was conducted at the end of the current seasonal influenza epidemic. The percentage of negative samples in our study was 52.4% versus 44.4% in the Italian group, but it should be noted samples were tested not only for viruses but also for other bacteria (5.6%). A Chinese study by Lin et al. 5 reported a 40.8% rate of negativity versus other respiratory viruses, considering that an undetermined percentage could be caused by other respiratory pathogens.

Our study detected 4 patients (2.1%) with concomitant infections with SARS-CoV-2 and other respiratory viruses, whereas the same rate in the Italian study was 4.8%. 4 The viruses detected in our study were the same as those reported by Bordi et al., 4 apart from coronavirus OC43, of which those researchers did not detect any cases. This virus is also a J o u r n a l P r e -p r o o f beta-coronavirus, but belongs to subgroup 2a, and therefore genetically distant from SARS-CoV-2 (Sarbecovirus 2b). As a result, we do not believe that represents cross-amplification.

Furthermore, among the cases that tested positive for other viruses and negative for SARS-CoV-2, we also detected 3 patients infected with coronavirus OC43, which was prevalent in the conventional respiratory infections during the study week. A Chinese study by Lin et al. 5 on concomitant infections between SARS-CoV-2 and other respiratory viruses detected 18 patients (9.7%) with this type of infection; this percentage was higher than that detected in this study and the Italian study, although the Chinese study was conducted in the second week in January 2020.

These preliminary studies suggest that SARS-CoV-2 would behave like all other conventional respiratory viruses in that it would present as a concomitant infection in a variable percentage (4%-9%). Therefore, initial detection of influenza or RSV as a process for ruling out COVID-19 should not be continued. If this new infection is suspected, inevitably, it is necessary to initially rule out this virus and then, if possible, simultaneously test for other respiratory viruses.

J o u r n a l P r e -p r o o f

Global surveillance for human infection with coronavirus disease (COVID-2019)

Novel coronavirus (2019-nCoV) technical guidance

Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR

Differential diagnosis of illness in patients under investigation for the novel coronavirus (SARS-CoV-2)

Co-infections of Sars-CoV-2 with multiple common respiratory pathogens in infected patients