OBJECTIVES: To determine the rate of coinfections and its subsequent impact on hospitalization and mortality rate in Indian COVID-19 patients.

METHODS: A systematic literature search was performed on PubMed, Cochrane, WHO COVID-19 database, Google Scholar and assisted by MaiA tool at various steps. The studies were retrieved and included based on JBI’s CoCoPop framework. Meta-analysis was not performed due to a limited number of studies and high heterogeneity. Descriptive statistics were summarized based on the retrieved coinfections data. The protocol was registered with PROSPERO – CRD42021275644.

RESULTS: A total of 2418 patients were included from eight studies. The prevalence of coinfections ranged from 4% - 46%. Pathogen-specific data showed highest prevalence of bacterial (57.3%), followed by parasitic (21.1.%), viral (14.6%), and fungal coinfections (6.9%). About 60% - 80% of the patients with coinfections required ICU admissions. Among coinfected COVID-19 patients, the average length of hospital stay was 13.67+3.51 days. The mortality rate of COVID-19 patients with coinfections ranged from 9%-65%.

CONCLUSIONS: Bacterial coinfections have the highest prevalence among COVID-19 patients. A causal relationship between coinfections and mortality rate in COVID-19 patients remains unexplored. This brings up the need for comprehensive data recording practices and meticulous reporting. Further, large-scale epidemiologic studies are the need of the hour to determine the nationwide burden of coinfections in the COVID-19 pandemic.