SARS-CoV-2 and influenza coinfection throughout the COVID-19 pandemic: an assessment of coinfection rates, cohort characteristics, and clinical outcomes.
SARS-CoV-2 and influenza coinfection throughout the COVID-19 pandemic: an assessment of coinfection rates, cohort characteristics, and clinical outcomes.
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DOI：
10.1093/pnasnexus/pgac071
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发表时间：
2022-07
期刊：
影响因子：
--
通讯作者：
Soundararajan V
中科院分区：
文献类型：
--
作者：
Pawlowski C;Silvert E;O'Horo JC;Lenehan PJ;Challener D;Gnass E;Murugadoss K;Ross J;Speicher L;Geyer H;Venkatakrishnan AJ;Badley AD;Soundararajan V
感染COVID-19和流感病毒（“氟罗那”）患者的病例报告引发了人们对合并感染的患病率和严重程度的质疑。利用HHS保护公共数据中心、NCBI病毒和CDC FluView的数据，我们分析了SARS-CoV-2和流感住院合并感染病例和菌株流行率的趋势。我们还对2020年1月至2022年4月期间梅奥诊所企业的合并感染病例进行了分析。我们比较了不同大流行浪潮中预期和观察到的合并感染病例数，并在倾向评分与临床相关基线特征匹配后，评估了合并感染和COVID-19单感染病例的症状和结局。从梅奥诊所和全国数据集来看，在欧米克隆时代（2021年12月14日至2022年4月2日），观察到的SARS-CoV-2和流感的合并感染率比之前的波浪要高，但假设感染率是独立的，并不高于预期。在梅奥诊所，在197364例SARS-CoV-2病例中，只有120例合并感染。合并感染的患者相对年轻（平均年龄：26.7岁），与单一感染的患者相比，严重的合并症较少。虽然合并感染和匹配的COVID-19单感染病例在30天住院率、ICU住院率或死亡率方面没有显著差异，但合并感染病例报告的充血、咳嗽、发烧/发冷、头痛、肌痛/关节痛、咽炎和鼻炎等症状发生率更高。虽然在梅奥诊所观察到的大多数合并感染病例发生在相对健康的个体中，但需要进一步观察以评估具有严重COVID-19危险因素（如年龄较大、肥胖和免疫功能低下）的亚人群的结局。
Case reports of patients infected with COVID-19 and influenza virus (“flurona”) have raised questions around the prevalence and severity of coinfection. Using data from HHS Protect Public Data Hub, NCBI Virus, and CDC FluView, we analyzed trends in SARS-CoV-2 and influenza hospitalized coinfection cases and strain prevalences. We also characterized coinfection cases across the Mayo Clinic Enterprise from January 2020 to April 2022. We compared expected and observed coinfection case counts across different waves of the pandemic and assessed symptoms and outcomes of coinfection and COVID-19 monoinfection cases after propensity score matching on clinically relevant baseline characteristics. From both the Mayo Clinic and nationwide datasets, the observed coinfection rate for SARS-CoV-2 and influenza has been higher during the Omicron era (2021 December 14 to 2022 April 2) compared to previous waves, but no higher than expected assuming infection rates are independent. At the Mayo Clinic, only 120 coinfection cases were observed among 197,364 SARS-CoV-2 cases. Coinfected patients were relatively young (mean age: 26.7 years) and had fewer serious comorbidities compared to monoinfected patients. While there were no significant differences in 30-day hospitalization, ICU admission, or mortality rates between coinfected and matched COVID-19 monoinfection cases, coinfection cases reported higher rates of symptoms including congestion, cough, fever/chills, headache, myalgia/arthralgia, pharyngitis, and rhinitis. While most coinfection cases observed at the Mayo Clinic occurred among relatively healthy individuals, further observation is needed to assess outcomes among subpopulations with risk factors for severe COVID-19 such as older age, obesity, and immunocompromised status.
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