Clinical characteristics of critically ill patients co-infected with SARS-CoV-2 and the influenza virus in Wuhan, China

• Published in: International journal of infectious diseases Vol. 96; pp. 683 - 687
• Main Authors: Ma, Simin, Lai, Xiaoquan, Chen, Zhe, Tu, Shenghao, Qin, Kai
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.07.2020; The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases; Elsevier
• Subjects: Aged; Betacoronavirus; China - epidemiology; Co-infection; Coinfection - virology; Coronavirus Infections - complications; Coronavirus Infections - diagnosis; COVID-19; Critical Illness; Cytokine storm; Female; Fibrin Fibrinogen Degradation Products - analysis; Hospitalization; Humans; Influenza; Influenza, Human - complications; Influenza, Human - diagnosis; Leukocyte Count; Male; Middle Aged; Organ injury; Pandemics; Pneumonia, Viral - complications; Pneumonia, Viral - diagnosis; SARS-CoV-2; Tumor Necrosis Factor-alpha - blood; China; COVID-19; Co-infection; Cytokine storm; Influenza; Organ injury
• ISSN: 1201-9712; 1878-3511; 1878-3511
• DOI: 10.1016/j.ijid.2020.05.068

•A high proportion of COVID-19 patients were co-infected with influenza in Tongji Hospital (Wuhan).•Critically ill COVID-19 patients with influenza were more prone to cardiac injury than those without influenza.•Co-infection with the influenza virus may induce an earlier and more frequently occurring cytokine storm in critically ill COVID-19 patients.•Do not ignore detection of the influenza virus in patients with COVID-19. To delineate the clinical characteristics of critically ill COVID-19 patients co-infected with influenza. This study included adult patients with laboratory-confirmed COVID-19 form Tongji Hospital (Wuhan, China), with or without influenza, and compared their clinical characteristics. Among 93 patients, 44 died and 49 were discharged. Forty-four (47.3%) were infected with influenza virus A and two (2.2%) with influenza virus B. Twenty-two (50.0%) of the non-survivors and 24 (49.0%) of the survivors were infected with the influenza virus. Critically ill COVID-19 patients with influenza were more prone to cardiac injury than those without influenza. For the laboratory indicators at admission the following were higher in non-survivors with influenza than in those without influenza: white blood cell counts, neutrophil counts, levels of tumor necrosis factor-α, D-dimer value, and proportion of elevated creatinine. The results showed that a high proportion of COVID-19 patients were co-infected with influenza in Tongji Hospital, with no significant difference in the proportion of co-infection between survivors and non-survivors. The critically ill COVID-19 patients with influenza exhibited more severe inflammation and organ injury, indicating that co-infection with the influenza virus may induce an earlier and more frequently occurring cytokine storm.