The interactions of SARS-CoV-2 with cocirculating pathogens: Epidemiological implications and current knowledge gaps Article Swipe
YOU?
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· 2023
· Open Access
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· DOI: https://doi.org/10.1371/journal.ppat.1011167
Despite the availability of effective vaccines, the persistence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) suggests that cocirculation with other pathogens and resulting multiepidemics (of, for example, COVID-19 and influenza) may become increasingly frequent. To better forecast and control the risk of such multiepidemics, it is essential to elucidate the potential interactions of SARS-CoV-2 with other pathogens; these interactions, however, remain poorly defined. Here, we aimed to review the current body of evidence about SARS-CoV-2 interactions. Our review is structured in four parts. To study pathogen interactions in a systematic and comprehensive way, we first developed a general framework to capture their major components: sign (either negative for antagonistic interactions or positive for synergistic interactions), strength (i.e., magnitude of the interaction), symmetry (describing whether the interaction depends on the order of infection of interacting pathogens), duration (describing whether the interaction is short-lived or long-lived), and mechanism (e.g., whether interaction modifies susceptibility to infection, transmissibility of infection, or severity of disease). Second, we reviewed the experimental evidence from animal models about SARS-CoV-2 interactions. Of the 14 studies identified, 11 focused on the outcomes of coinfection with nonattenuated influenza A viruses (IAVs), and 3 with other pathogens. The 11 studies on IAV used different designs and animal models (ferrets, hamsters, and mice) but generally demonstrated that coinfection increased disease severity compared with either monoinfection. By contrast, the effect of coinfection on the viral load of either virus was variable and inconsistent across studies. Third, we reviewed the epidemiological evidence about SARS-CoV-2 interactions in human populations. Although numerous studies were identified, only a few were specifically designed to infer interaction, and many were prone to multiple biases, including confounding. Nevertheless, their results suggested that influenza and pneumococcal conjugate vaccinations were associated with a reduced risk of SARS-CoV-2 infection. Finally, fourth, we formulated simple transmission models of SARS-CoV-2 cocirculation with an epidemic viral pathogen or an endemic bacterial pathogen, showing how they can naturally incorporate the proposed framework. More generally, we argue that such models, when designed with an integrative and multidisciplinary perspective, will be invaluable tools to resolve the substantial uncertainties that remain about SARS-CoV-2 interactions.
Related Topics
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1371/journal.ppat.1011167
- https://journals.plos.org/plospathogens/article/file?id=10.1371/journal.ppat.1011167&type=printable
- OA Status
- gold
- Cited By
- 29
- References
- 110
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4323535357
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4323535357Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1371/journal.ppat.1011167Digital Object Identifier
- Title
-
The interactions of SARS-CoV-2 with cocirculating pathogens: Epidemiological implications and current knowledge gapsWork title
- Type
-
reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-03-08Full publication date if available
- Authors
-
Anabelle Wong, Laura Andrea Barrero Guevara, Elizabeth Goult, Michael Briga, Sarah Krämer, Aleksandra Kovacevic, Lulla Opatowski, Matthieu Domenech de CellèsList of authors in order
- Landing page
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https://doi.org/10.1371/journal.ppat.1011167Publisher landing page
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https://journals.plos.org/plospathogens/article/file?id=10.1371/journal.ppat.1011167&type=printableDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://journals.plos.org/plospathogens/article/file?id=10.1371/journal.ppat.1011167&type=printableDirect OA link when available
- Concepts
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Coinfection, Biology, Disease, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Influenza A virus, Virology, Immunology, Coronavirus disease 2019 (COVID-19), Virus, Medicine, Infectious disease (medical specialty), Internal medicineTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
29Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 6, 2024: 20, 2023: 1, 2022: 2Per-year citation counts (last 5 years)
- References (count)
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110Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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