81 Viral co-infections in SARS-CoV-2 4 Clinical features associated with respiratory virus co-infection We first sought to understand the characteristics of the sub-group of patients undergoing testing for respiratory viruses in addition to SARS-CoV-2 (Supplementary table 3). Overall, additional testing was associated with more severe disease. The proportion of patients admitted to critical care was higher among those undergoing additional testing (27.6% vs. 16.4%) as was the proportion of people who received IMV (10.4% vs 4.7%). Within the sub-group of tested patients with a documented positive or negative result (n=6965) we then analysed patient characteristics and outcomes associated with co-infection (Table 1). In an unadjusted analysis, patients with respiratory virus coinfections were older. The highest proportion of people needing IMV was observed in people with influenza co-infection (23.5%), followed by 16.8% of RSV co-infected patients, 16.2% of SARS-CoV-2 mono-infected patients and 15.4% of adenovirus co-infections. In-hospital mortality was higher in all co-infection groups compared to SARS-CoV-2 mono-infection. 225,526 subjects in database on December 8, 2021 212,466 included 17,011 subjects that were tested 105,736 subjects that were not tested 89,719 subjects with unknown testing status 13,060 excluded: 9,798 with age under 18 years 3,118 with negative SARS-CoV-2 PCR 144 with probable test result 583 co-infections 6382 not co-infected 10,046 unknown results 136 Adenovirus 227 Influenza 220 RSV Figure 1: Study flowchart
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