Small study shows patients with SARS-CoV-2, flu coinfection not worse off
Click Here to Manage Email Alerts
A small study in New York found no difference in outcomes among patients with COVID-19 compared with patients who had both influenza and COVID-19, according to data presented at IDWeek.
“Early in the pandemic, when everything was new, in the news there was a report mentioning that COVID-19 and influenza coinfection was not possible. Then some reports in China confirmed coinfection but only a few cases,” Renato G. Bobadilla, MD, a medical resident at Saint Barnabas Hospital in New York, told Healio. “However, here in the Bronx, we were hit earlier than other states, coinciding with the last months of flu season. Given this fact, we had a small but significant group of patients which were positive for both tests.”
According to Bobadilla, this raised concerns that COVID-19 and influenza coinfection would lead to worse outcomes.
“In our hospital during winter, general medical floor and intensive care unit hospitalization rates are increased due to influenza,” Bobadilla added. “Imagining a worse scenario and considering our first experience with COVID-19 was overwhelming, Dr. Victoria Bengualid, our program director, liked this idea and helped us to start a case control study in our hospital population.”
Bobadilla and colleagues assessed the outcomes of 18 patients with influenza and COVID-19 in a case-control study. They assessed coinfected patients and controls for in-hospital mortality, need for mechanical ventilation, need for vasopressors and need for renal replacement therapy.
An analysis demonstrated that there was no significant difference between coinfected vs. monoinfected patients for in-hospital mortality (OR = 0.769; 95% CI, 0.185-3.191), need for mechanical ventilation (OR = 1.3; 95% CI, 0.313-5.393), need for vasopressors (OR = 1.923; 95% CI, 0.383-9.646) or need for renal replacement therapy (OR = 1.0; 95% CI, 0.208-4.814).
Bobadilla noted that, at the time of the study, an effective treatment for COVID-19 was not yet recommended and that the researchers could only study a specific period of time, given that the COVID-19 standard of care changed frequently and rapidly with each passing day.
“COVID-19 should be suspected in every patient who arrives to the emergency department with fever or shortness of breath, and influenza coinfection should be suspected, too, especially in the upcoming months and given the fact that both are transmitted similarly,” Bobadilla said. “Our results did not show a worse outcome with coinfection, but our number of cases was low, so it might change in a future.”
Experts have expressed concern over the potential for a COVID-19 and influenza “twindemic,” but data has shown that efforts to prevent COVID-19 have led to a global decline in influenza.
“We do not know how much social distancing will decrease the incidence of influenza cases for this flu season, but we have to keep in mind that keeping the mask on will decrease the spread of COVID-19 and also the flu,” Bobadilla said.
Perspective
Back to Top
Further investigation is needed to better understand the dangers associated with coinfection with influenza and SARS-CoV-2. Although these findings are notable, we should not ignore previous research in larger populations that suggests patients coinfected with both viruses face a higher risk of poor outcomes. In addition, this study does not appear to account for patients with chronic health conditions, who face an increased risk of severe symptoms from influenza and COVID-19.
We must continue to prioritize all available preventive measures to protect at-risk individuals from these viruses. As noted in a recent National Foundation for Infectious Diseases (NFID) Call to Action, although there is currently no approved COVID-19 vaccine in the United States, annual influenza vaccination can protect high-risk patients from influenza, reducing the incidence of coinfection and lowering influenza-associated hospitalization rates and additional strain on the U.S. health care system.
Collapse
Bobadilla RG, et al. Abstract 62. Presented at: IDWeek; Oct. 21-25, 2020 (virtual meeting).
Read more about
Click Here to Manage Email Alerts