21 Nov Coinfection with SARS-CoV-2 among patients with Streptococcus pneumoniae in Casablanca
M. Katfy , A. E Kettani , K. Katfy , I. Diawara , N. Nzoyikorera , S. Boussetta , M. S Abdallaoui2 , A. A Bousfiha
Abstract
Background During the COVID-19 pandemic caused by SARS-CoV-2, coinfections with Streptococcus pneumoniae
have emerged as a significant public health concern. The impact of these coinfections on disease severity and
mortality rates remains underexplored. This study aims to address this gap by analyzing the clinical outcomes of
patients coinfected with S. pneumoniae and SARS-CoV-2 at CHU Ibn Rochd in Casablanca, Morocco, between 2020
and 2022.
Methods A cohort of 120 hospitalized patients diagnosed with S. pneumoniae infection was studied retrospectively
and prospectively. Clinical and demographic data, vaccination status, and infection characteristics were collected.
Among these patients, 41 were identified as coinfected with both pathogens. Statistical analyses, including
multivariate logistic regression, were performed to assess associations between coinfection and clinical outcomes,
such as ICU admission and mortality.
Results Compared to non-coinfected patients, those coinfected with SARS-CoV-2 had higher ICU admission (53.7%
vs. 24.05%) and mortality (39.02% vs. 13.9%) rates. Multivariate analysis identified coinfection and increasing age
as independent predictors of severe outcomes. The most frequent pneumococcal serotypes were 3, 19 A, 6 B, and
9 V, with 31.7% of cases involving non-vaccine types. Most coinfected patients, especially those who died, were
unvaccinated against pneumococcus or SARS-CoV-2.
Conclusions Coinfection with SARS-CoV-2 significantly increases the risk of severe outcomes in patients with S.
pneumoniae infection. These findings highlight the importance of early detection and support the implementation of
comprehensive vaccination strategies targeting high-risk populations.