COVID-19 does not increase risk of Streptococcus pneumoniae infection

*Important Notices: medrex sib We publish a non-peer-reviewed, preliminary scientific report and should not be taken as conclusive, to guide clinical practice/health-related actions, or to be treated as established information.

In a recent study posted on medrex sib* In a preprint server, researchers will investigate the effects of upper respiratory tract (URT) colonization. Streptococcus pneumoniae Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vice versa among children and non-elderly adults in the household.

Here, researchers conducted a longitudinal prospective observational study in Dutch households. The member tested positive for coronavirus disease 2019 (COVID-19) through a reverse transcription-polymerase chain reaction (RT-PCR) assay 3 days before his enrollment in the study. Two other family members of her also agreed to participate in the study.

study: Longitudinal dynamics of S. pneumoniae carriage and SARS-CoV-2 infection in households with children. Image credit: Lotus_studio / Shutterstock.com

Background

During the first years of the COVID-19 pandemic, the incidence of invasive pneumococcal disease (IPD) was Streptococcus pneumoniae Significant declines in multiple countries. Scientists believe that the large-scale implementation of non-pharmaceutical interventions (NPIs) has limited pneumococcal infections and his IPD outbreaks throughout the pandemic.

However, several other studies have shown that these declines are due to reduced circulating seasonal respiratory viruses rather than reduced pneumococcal infections.

Nevertheless, certain respiratory viruses and Streptococcus pneumoniae It seems that there is a synergistic effect.inflammation caused by Streptococcus pneumoniae URT facilitates infection by respiratory viruses, and this response inhibits the innate immune response and prevents the URT microbiota from promoting pneumococcal colonization, thereby increasing the risk of secondary pneumococcal pneumonia. increase.

Few studies assess co-infection with SARS-CoV-2 and pneumococci or virus-bacteria interactions. Furthermore, the long-term effects of potential interference between these two pathogens in households with children and non-elderly persons under 65 years of age also remain largely unknown.

About research

In the present study, researchers used quantitative molecular methods to detect Streptococcus pneumoniae SARS-CoV-2 in saliva samples self-collected from members of eight participating households between October 2020 and January 2021.

The study included 197 adults and 118 children under the age of 65. Of these, 176 adults and her 98 children provided her 10 self-collected saliva samples within 42 days of enrollment in this study.

Relative pneumococcal abundance was calculated by dividing pneumococcal abundance by overall bacterial abundance (16S) and compared using a permutation test equivalent to the Mann-Whitney U test.

The team then used linear mixed-effects modeling to explore correlations between SARS-CoV-2 infection, pneumococcal colonization status, and bacterial (16S) abundance. Here, individuals at one time point were classified as having low or high 16S abundance. A random intercept accounted for the longitudinal intra- and interpersonal variance.

A time-dependent Cox proportional hazards model was used to assess the relationship between SARS-CoV-2 and pneumococcal carriage, abundance, and log-transformed global bacterial (16S) abundance. For age-specific hazard ratios (HR), her two age groups were considered, including children <18 years and adults >18 years.

Investigation result

high transport rate Streptococcus pneumoniae remained relatively constant in Dutch households during the study period. This is likely due to the nationwide implementation of the NPI, which has reduced the circulation of seasonal respiratory viruses.

Although pneumococcal carriers appeared to be at higher risk of SARS-CoV-2 infection and had delayed viral clearance, we found that SARS-CoV-2 had a strong impact on pneumococcal carriage and abundance. There was insufficient evidence to show that and vice versa.

Individuals with high pneumococcal carriage and high 16S load also had increased SARS-CoV-2 viral load at multiple time points, suggesting an impact on the progression of COVID-19. However, the variability in longitudinal viral load trajectories between these samples was not significant and this could be due to her COVID-19-induced abnormalities in her URT microbiome.

Previous studies have also described a different URT microbiome composition profile in hospitalized COVID-19 patients compared to healthy individuals. Regarding the relative abundance of pneumococci, no significant differences were observed between SARS-CoV-2-infected and non-infected subjects, and no significant changes were observed in the serotype composition of all samples during the study period. .

Several studies documented that pneumococcal carriage rates in children were relatively unaffected during the COVID-19 pandemic. Cumulative HRs for the entire study were 2.14 and 0.83, respectively, which were higher in children than in adults. This suggests that the relationship between pneumococcal abundance and SARS-CoV-2 infection was relevant in children.

Conclusion

Taken together, study observations suggest that SARS-CoV-2 infection does not appear to affect pneumococcal colonization, which suggests that SARS-CoV-2 and pneumococcal co-infection is consistent with previous studies showing that is rare.

However, pneumococcal carriers, especially children, were at increased risk of contracting COVID-19. Furthermore, the results of this study suggest a correlation between high abundance of pneumococci and 16S and increased viral load, apart from delayed clearance of SARS-CoV-2 infection.

*Important Notices: medrex sib We publish a non-peer-reviewed, preliminary scientific report and should not be taken as conclusive, to guide clinical practice/health-related actions, or to be treated as established information.