SARS-CoV-2 Coinfections and Severity in Hospitalized Children With Systematic Testing.

Cohort studyThe Pediatric infectious disease journal· Sep 2026

SARS-CoV-2 Coinfections and Severity in Hospitalized Children With Systematic Testing.

Costanza Di Chiara, Daniel S Farrar, Julie A Bettinger … for Members of the Canadian Immunization Monitoring Program, Active (IMPACT) COVID-19 Study

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Pediatric Infection & VaccinationCohort studyQ1IF 1.7

Respiratory viral coinfections not associated with severe COVID-19 in hospitalized children at centres with systematic multiplex polymerase chain reaction testing

SARS-CoV-2 Coinfections and Severity in Hospitalized Children With Systematic Testing.

Costanza Di Chiara … for Members of the Canadian Immunization Monitoring Program, Active (IMPACT) COVID-19 Study

The Pediatric infectious disease journal · Sep 2026 · Q1 in Pediatrics

Background

Co-circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with other respiratory viruses raised concerns that coinfections may increase pediatric coronavirus disease 2019 (COVID-19) severity, but evidence is limited by variable testing practices.

Methods

We analyzed national surveillance data from the Canadian Immunization Monitoring Program, ACTive (IMPACT) COVID-19 study.

n = 5

Results

coinfection did not raise odds of severe COVID-19 in centres testing every admission

AOR by subgroup · 95% CI

More results

Among 2831 hospitalized children, 938 were admitted at centers with systematic multiplex polymerase chain reaction testing, among whom 18.6% had ≥1 respiratory viral coinfection.

Respiratory syncytial virus (39.7%) and enterovirus/rhinovirus (38.5%) coinfections were the most common.

More results

In secondary analyses including all centers irrespective of testing strategy, coinfections were associated with increased odds of severe COVID-19 (aOR 1.42; 95% confidence interval, 1.05-1.91).

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Conclusion · 1 of 2

In centers that systematically conducted multiplex polymerase chain reaction testing, SARS-CoV-2 respiratory viral coinfections were not associated with increased COVID-19 severity.

Conclusion · 2 of 2

Differences observed when including centers without systematic testing underscore the importance of considering testing strategies when evaluating the clinical impact of coinfections.

SARS-CoV-2 Coinfections and Severity in Hospitalized Children With Systematic Testing.

SARS-CoV-2 Coinfections and Severity in Hospitalized Children With Systematic Testing.

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