Respiratory Viral Co-Infections in SARS-CoV-2 Positive Patients in Burkina Faso: A Cross-Sectional Study.

BACKGROUND

The burden of viral co-infections among COVID-19 patients is underexplored in low-resource settings such as Burkina Faso. This study aimed to determine the prevalence and associated factors of respiratory viral co-infections among laboratory-confirmed COVID-19 patients.

METHODS

A cross-sectional study was conducted from January 1 to December 31, 2023, across 13 sentinel sites in Burkina Faso. Patients presenting with influenza-like illness or severe acute respiratory infection had nasopharyngeal and/or oropharyngeal swabs collected and tested for SARS-CoV-2 and other respiratory viruses using multiplex real-time RT-PCR. Descriptive statistics, univariate, and multivariate logistic regression analyses were performed to identify predictors of viral co-infections.

RESULTS

Among 201 SARS-CoV-2-positive patients enrolled (median age: 1 year; interquartile range: 0.5-7). Co-infections was identified in 48.8% (95% CI: 41.8-55.6) of cases and a single co-infections was detected in 33.8% (95% CI: 27.5-40.6) of patients. Human rhinovirus (17.9%), adenovirus (14.4%), respiratory syncytial virus (11.4%), and influenza A/B (9.9%) were most frequently detected. In multivariate analysis, children aged 6 months to 14 years had higher odds of co-infection (aOR 2.7; 95% CI: 1.2-5.9; p = 0.013). Fever (aOR 2.6; 95% CI: 1.3-5.5; p = 0.008) and hospitalization (aOR 4.3; 95% CI: 1.6-12.0; p = 0.005) were also independently associated with co-infection.

CONCLUSION

Viral co-infections were frequent among SARS-CoV-2 positive patients, particularly in children and hospitalized individuals. Strengthening multiplex diagnostic capacity and integrated respiratory virus surveillance in resource-limited settings may improve clinical management and inform public health response strategies.