Viral interference with SARS-CoV-2 during the COVID-19 pandemic: An individual participant data meta-analysis
Year: 2026
Type: review
Abstract: Viral interference between SARS-CoV-2 and other respiratory virus infections has been implicated, but symptom-based testing in observational studies may bias estimations. We used individual participant data from ten cohort studies conducted during pandemic years 2020–2024 to study virus interference. Respiratory samples were PCR-tested for viruses including SARS-CoV-2. The primary analysis was based on samples collected from cohort participants regardless of respiratory symptoms. A secondary analysis included only symptom-based testing data. We estimated odds ratios for co-occurrence of SARS-CoV-2 with other respiratory viruses. The primary analysis included data from six cohorts ( n = 1 023). In total 205 of 2 465 samples were SARS-CoV-2 positive (8.3%). Co-detections with SARS-CoV-2 occurred less frequently than expected under the assumption of zero interference (OR: 0.72; 95% CI: 0.40–1.25) for samples positive for another virus. The secondary analysis (five cohorts, n = 1 715) included 2 088 samples from symptomatic subjects, with 506 SARS-CoV-2 infections (24.2%). The OR of SARS-CoV-2 detection was 0.16 (95% CI: 0.10–0.25) for samples positive for another virus. Minimizing selection bias, our results still point towards negative viral interference with SARS-CoV-2, but effect-estimates are weaker and non-significant. Apart from selection bias, the stronger effects found in symptomatic individuals could also indicate that symptomatic infection enhances virus interference.
Source: Epidemiology and Infection
Authors: Emma S. E. M. Hauser-van Westrhenen, Marieke L. A. De Hoog, Angelique M. A. M. Winkel, Laia Junquera Guinovart, A. H. Ayesha Lavell, Menno D. de Jong, Marlies A. van Houten, Steven F. L. van Lelyveld, Dirk Eggink, Sjoerd Euser, Liesbeth Duijts, Joanne G. Wildenbeest, Rob Schuurman, Janneke H. H. M. van de Wijgert, Margareta Ieven, Katherine Loens, Alike W. van der Velden, Marc J. M. Bonten, Herman Goossens, Patricia C. J. L. Bruijning-Verhagen
Institutions: University Medical Center Utrecht, Amsterdam UMC Location University of Amsterdam, Spaarne Ziekenhuis, Amsterdam University Medical Centers, Amsterdam UMC Location Vrije Universiteit Amsterdam, Spaarne Gasthuis, National Institute for Public Health and the Environment, Erasmus MC, University of Antwerp
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,550
OpenAlex ID: W7221807855