{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T16:13:30Z","timestamp":1792858410350,"version":"4.5.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Streptococcus pneumoniae coinfection with influenza results in synergistic lethality, but there are limited data on pneumococcal coinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Public Health England conducts invasive pneumococcal disease (IPD) and SARS-CoV-2 surveillance in England. IPD trends during 2000\/2001\u20132019\/2020 epidemiological years were analyzed and cases during February\u2013June 2020 linked with laboratory-confirmed SARS-CoV-2 infections. Multivariable logistic regression was used to assess risk factors for death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>IPD incidence in 2019\/2020 (7.6\/100 000; n\u2005=\u20053964) was 30% (IRR, .70; 95% CI, .18\u20132.67) lower compared with 2018\/2019 (10.9\/100 000; n\u2005=\u20055666), with large reductions observed across all age groups during March\u2013June 2020. There were 160 886 SARS-CoV-2 and 1137 IPD cases during February\u2013June 2020, including 40 IPD\/coronavirus disease 2019 (COVID-19) co-infections (.025% [95% CI, .018\u2013.034] of SARS-CoV-2 infections; 3.5% [2.5\u20134.8] of IPD cases), 21 with COVID-19 diagnosed 3\u201327 days after IPD, and 27 who developed COVID-19 \u226528 days after IPD. Case-fatality rates (CFRs) were 62.5 (25\/40), 47.6% (10\/21), and 33.3% (9\/27), respectively (P\u2005&amp;lt;\u2005.001). In addition to an independent association with increasing age and serotype group, CFR was 7.8-fold (95% CI, 3.8\u201315.8) higher in those with IPD\/COVID-19 coinfection and 3.9-fold (95% CI, 1.4\u201310.7) higher in patients who developed COVID-19 3\u201327 days after IPD compared with patients with IPD only.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Large declines in IPD were observed following COVID-19 lockdown. IPD\/COVID-19 coinfections were rare but associated with high CFR, mainly in older adults. The rarity, age and serotype distribution of IPD\/COVID-19 coinfections do not support wider extension of pneumococcal vaccination.<\/jats:p><\/jats:sec>","DOI":"10.1093\/cid\/ciaa1728","type":"journal-article","created":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T04:15:14Z","timestamp":1605154514000},"page":"e65-e75","source":"Crossref","is-referenced-by-count":159,"title":["Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Invasive Pneumococcal Disease and Risk of Pneumococcal Coinfection With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): Prospective National Cohort Study, England"],"prefix":"10.1093","volume":"72","author":[{"given":"Zahin","family":"Amin-Chowdhury","sequence":"first","affiliation":[{"name":"Immunisation and Countermeasures Division, Public Health England, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicity","family":"Aiano","sequence":"additional","affiliation":[{"name":"Immunisation and Countermeasures Division, Public Health England, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Mensah","sequence":"additional","affiliation":[{"name":"Immunisation and Countermeasures Division, Public Health England, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen L","family":"Sheppard","sequence":"additional","affiliation":[{"name":"Respiratory and Vaccine Preventable Bacterial Reference Unit (RVBRU), Public Health England, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Litt","sequence":"additional","affiliation":[{"name":"Respiratory and Vaccine Preventable Bacterial Reference Unit (RVBRU), Public Health England, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman K","family":"Fry","sequence":"additional","affiliation":[{"name":"Immunisation and Countermeasures Division, Public 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