Julia Stowe1, Elise Tessier1, H Zhao1, Rebecca Guy2, Berit Muller-Pebody2, Maria Zambon3, Nick Andrews4, Mary Ramsay1, Jamie Lopez Bernal1. 1. Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK. 2. Healthcare Associated Infections and Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK. 3. Virus Reference Department, National Infection Service, Public Health England, London, UK. 4. Statistics, Modelling and Economics Department, National Infection Service, Public Health England, London, UK.
Abstract
BACKGROUND: The impact of SARS-CoV-2 alongside influenza is a major concern in the northern hemisphere as winter approaches. METHODS: Test data for influenza and SARS-CoV-2 from national surveillance systems between 20 January 2020 and 25 April 2020 were used to estimate influenza infection on the risk of SARS-CoV-2 infection. A test-negative design was used to assess the odds of SARS-CoV-2 in those who tested positive for influenza compared with those who tested negative. The severity of SARS-CoV-2 was also assessed using univariable and multivariable analyses. RESULTS: The risk of testing positive for SARS-CoV-2 was 58% lower among influenza-positive cases and patients with a coinfection had a risk of death of 5.92 (95% confidence interval: 3.21-10.91) times greater than among those with neither influenza nor SARS-CoV-2. The odds of ventilator use or death and intensive care unit admission or death were greatest among coinfected patients. CONCLUSIONS: Coinfection of these viruses could have a significant impact on morbidity, mortality and health-service demand.
BACKGROUND: The impact of SARS-CoV-2 alongside influenza is a major concern in the northern hemisphere as winter approaches. METHODS: Test data for influenza and SARS-CoV-2 from national surveillance systems between 20 January 2020 and 25 April 2020 were used to estimate influenzainfection on the risk of SARS-CoV-2 infection. A test-negative design was used to assess the odds of SARS-CoV-2 in those who tested positive for influenza compared with those who tested negative. The severity of SARS-CoV-2 was also assessed using univariable and multivariable analyses. RESULTS: The risk of testing positive for SARS-CoV-2 was 58% lower among influenza-positive cases and patients with a coinfection had a risk of death of 5.92 (95% confidence interval: 3.21-10.91) times greater than among those with neither influenza nor SARS-CoV-2. The odds of ventilator use or death and intensive care unit admission or death were greatest among coinfected patients. CONCLUSIONS:Coinfection of these viruses could have a significant impact on morbidity, mortality and health-service demand.
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