Abstract
Streptococcus pneumoniae is the major cause of community acquired pneumonia. The clinical picture of other respiratory infections such as influenza or SARS-CoV-2 may resemble that of pneumonia. During pandemics, such as the 1918 influenza pandemic and COVID-19, S. pneumoniae could come in disguise and contribute to overall morbidity and mortality. It is estimated that during the 1918 influenza pandemic up to 50% of deaths were due to S. pneumoniae co- or super-infections. A century later, during COVID-19 estimates are that pneumococcal pneumonia contributed to up to 10% of morbidity. Adequate diagnostic procedures and treatment, as well as optimalization of pneumococcal vaccination programs could reduce the burden of pneumococcal disease, also in times of pandemics.