Synergistic interactions between respiratory viruses and Streptococcus pneumoniae(pneumococcus) have been extensively investigated. Although impactful viral–pneumococcal interactions have been described with common respiratory viruses, including human rhinovirus and respiratory syncytial virus [1–4], these interactions have been most widely studied with influenza and pneumococcus, in part, prompted by the dramatically increased mortality due to secondary pneumococcal pneumonia during the 1918 influenza A/H1N1 pandemic [5–12]. It has been hypothesized that respiratory viral infections create favorable conditions in the nasopharyngeal mucosa for colonizing pneumococci to invade, leading to mucosal disease such as pneumonia and otitis media, as well as invasive pneumococcal diseases (IPD), including bacteremia and meningitis. Several mechanisms for viral facilitation of bacterial colonization have been proposed. Respiratory viruses may alter the integrity of the respiratory epithelia, enhancing conditions for bacterial adherence and translocation, as well as inducing factors required for bacterial adherence and by influencing immunological defenses of the host epithelium [13]. Epidemiological and ecological observations suggest that coinfection with respiratory viruses such as influenza, human rhinovirus, and respiratory syncytial virus is common in children with pneumococcal pneumonia and IPD [14, 15], and rates of IPD temporally correlate with periods of high activity of these viruses [4, 16, 17].

Despite the widespread global effects of the coronavirus disease 2019 (COVID-19) pandemic, until now little has been reported regarding the potential bacterial, specifically, pneumococcal interactions with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus associated with COVID-19. Several earlier studies that used various methods and definitions to identify bacterial coinfections in patients hospitalized with COVID-19 have reported coinfection frequencies that ranged from 3.5% for confirmed community-onset bacterial infection [18] to 28% among patients admitted to the intensive care unit, when detections of respiratory bacteria in multiplex panels from upper respiratory samples were included in the definition [19–21]. In one study, while the overall frequency of secondary bacterial infection, defined as bacterial detection