Hospitalized adults who have COVID-19 and the flu at the same time (referred to as ‘flurone’) are at much higher risk of severe symptoms and death compared to patients who have COVID-19 alone or with other viruses , research published tonight shows in the magazine The Lancet. This research confirms another previous study published in August 2021 at International Journal of Epidemiology.
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Experts have found that patients co-infected with the SARS-CoV-2 virus and the flu virus are more than four times more likely to need respiratory support and 2.4 times more likely to die than if they had COVID alone. -19.
The researchers say the results demonstrate the need for more flu testing of COVID-19 patients in hospital and highlight the importance of full vaccination against both COVID-19 and influenza.
A team from the University of Edinburgh, the University of Liverpool, Leiden University and Imperial College London has reached these conclusions in a study with more than 305,000 hospitalized patients with COVID-19.
The largest study ever
The research – carried out within the framework of the International Consortium on Severe and Emerging Acute Respiratory Infections (ISARIC) for the clinical characterization of coronaviruses – is the largest study ever conducted on people with COVID-19 and other endemic respiratory viruses.
ISARIC was created in 2013 in anticipation of a pandemic like this. The team examined data from adults who had been hospitalized with COVID-19 in the UK between February 6, 2020, and December 8, 2021.
In total, the test results for respiratory viral coinfections of 6,965 patients with COVID-19 were recorded. Some 227 of them also had the flu virus, and they experienced significantly more severe outcomes.
Dr Maaike Swets, PhD student at the University of Edinburgh and Leiden University, points out in a statement: “In the last two years we have frequently observed that patients with COVID-19 became seriously ill, sometimes leading to admission to the ICU and the use of a ventilator to help them breathe. It was already known that a flu infection could give rise to a similar situation, but less was known about the results of a double infection of SARS-CoV-2 and other respiratory viruses.
An “especially dangerous” combination
Professor Kenneth Baillie, Professor of Experimental Medicine at the University of Edinburgh, adds: “We have found that the combination of COVID-19 and influenza viruses is particularly dangerous. This will be important as many countries decrease the use of social distancing and containment measures. We expect that COVID-19 will circulate with the flu, which will increase the possibility of co-infections. That is why we need to change our testing strategy for COVID-19 patients in the hospital and do much more extensive flu testing.”
Professor Calum Semple, Professor of Outbreak Medicine and Child Health at the University of Liverpool, points to an increase in the usual seasonal respiratory viruses as people mix back to normal: “So we can expect influenza to circulate along with COVID-19 this winter. We were surprised that the risk of death more than doubled when people were infected with both the flu and COVID-19 viruses. It is now very important that people get fully vaccinated and boosted against both viruses, and not put it off until it is too late.”
We must change our testing strategy for COVID-19 patients in hospital and do much more extensive flu testing
— Professor of Experimental Medicine at the University of Edinburgh
Likewise, Dr. Geert Groeneveld, a doctor at the department of infectious diseases at the Leiden University Medical Center, considers the consequences of double infections of SARS-CoV-2 and other respiratory viruses “crucial”, “since they have implications for the patients, hospitals, and ICU capacity during seasons when SARS-CoV-2 and influenza circulate together.”
Finally, Professor Peter Openshaw, Professor of Experimental Medicine at Imperial College London, points out that although being infected by more than one virus “is not very common” it is important to be aware that co-infections do occur. “The vaccines that protect against COVID-19 and the flu are different, and people need both. The way these two infections are treated is also different, so it is important to test for other viruses even when diagnosed in someone who is hospitalized with a respiratory infection.”