Co-infection of SARS-COV-2 and influenza A virus: a case series and fast review (preprint)

ABSTRACT

Background: COVID-19 has become a global pandemic. Studies about SARS-CoV-2 co-infection with influenza A virus (IAV) in the influenza season will contribute to the antiviral interventions of co-infected patients.Methods: A cohort of 145 COVID-19 patients in Wuhan union hospital were reviewed and we found 2 patients were co-infected with both SARS-CoV-2 and IAV. Then we searched from PubMed, Web of Science and CNKI with combinations of the following key words “COVID-19, SARS-COV-2, influenza A and co-infection” from January 1 up to May 1, and 6 studies were included in this descriptive analysis. Results: Of the 13 co-infected patients, 2 were from Wuhan union hospital, another 11 were collected from the reports published on PubMed, Web of Science and CNKI. Of the 13 patients, the median age was 50 years (IQR, 40.5-67.5). Among the 13 patients, 7 (53.8%) were severe types. The most common symptoms among the 13 patients were cough (100%), fever (92.3%) and dyspnea (76.9%). 8 patients had lymphocytopenia on admission and all the 13 patients had abnormal radiological changes. The median time from symptom onset to hospital admission was 4.5 days (IQR, 2.75-5.5), and the median time of hospital stay was 17 days (IQR,15-20). Conclusion: Patients with both SARS-COV-2 and IAV infection showed similar changes in symptoms and radiological images with patients infected with SARS-COV-2 only.  SARS-COV-2 co-infection with IAV can lead to more severe clinical condition but had similar hospital stay compared with patients infected with SARS-COV-2 only in the fast review.