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The Outbreak of Coronavirus Disease 2019 Interfered with Influenza in Wuhan

22 Pages Posted: 25 Mar 2020

See all articles by Xianlong Zhou

Xianlong Zhou

Wuhan University - Emergency Center

Guoyong Ding

Shandong First Medical University - School of Public Health

Ting Shu

Chinese Academy of Sciences (CAS) - State Key Laboratory of Virology

Shouzhi Fu

Wuhan Third Hospital - Department of Emergency & Intensive Care Unit

Weiwei Tong

Gennlife (Beijing) Biotechnology Co. Ltd.

Xiaopeng Tu

Wuhan University - Emergency Center

Shunqing Li

Wuhan University - Emergency Center

Di Wu

Chinese Academy of Sciences (CAS) - State Key Lab of Virology

Yang Qiu

Chinese Academy of Sciences (CAS) - State Key Laboratory of Virology

Jiangtao Yu

Wuhan University - Emergency Center

Song Cao

Wuhan Third Hospital - Department of Emergency & Intensive Care Unit

Cheng Jiang

Wuhan University - Emergency Center

Haoli Ma

Wuhan University - Department of Biological Repositories

Shaoping Li

Wuhan University - Emergency Center

Jian Xia

Wuhan University - Emergency Center

Zhigang Zhao

Wuhan University - Emergency Center

Zhiyong Peng

Wuhan University - Department of Critical Care Medicine

Yufeng Yuan

Wuhan University - Department of Hepatobiliary and Pancreatic Surgery

Mingxia Yu

Wuhan University - Department of Clinical Laboratory

Yirong Li

Wuhan University - Department of Clinical Laboratory

Zhiqiang Li

Wuhan University - Department of Neurosurgery

Weijia Xing

Chinese Academy of Sciences (CAS) - State Key Lab of Virology

Xi Zhou

Chinese Academy of Sciences (CAS) - State Key Lab of Virology

Yan Zhou

Wuhan University - Emergency Center

More...

Abstract

Background: Influenza co-circulates with coronavirus disease 2019 (COVID-19) in the space and time. Given the current situation of COVID-19 pandemic and influenza seasonal epidemic worldwide, there are lots of concerns about the potential co-infections or interactions between these two respiratory viruses. We aimed to study the potential interactions between them in Wuhan.

Methods: We obtained the epidemiological, demograhic and laboratory data from the COVID-19 and influenza cases visited the study hospital between January 2017 and February 2020. The co-infections of SARS-CoV-2 and influenza virus were retrospectively investigated in COVID-19 and influenza cases, and prospectively detected in the cases with fever and any other respiratory symptom visited the same hospital during February 14-24, 2020.

Findings: COVID-19 incidence dramatically increased in the end of January 2020 and reached the peak on February 4 in the study hospital. The seasonal epidemic of influenza was interrupted in January. A sharp decline of influenza A incidence and a premature plummet of influenza B incidence were observed. Negative correlations between the epidemic curves of COVID-19 and influenza A (r=-0.49, p<0.05) or influenza B (r=-0.51, p<0.05) were uncovered. Nine co-infections were retrospectively identified in 1054 cases of COVID-19 or influenza (0.9%, 95% CI: 0.4-1.6%). No co-infection was prospectively detected in 179 patients with fever and any respiratory symptom.

Interpretation: The emergence of COVID-19 interfered influenza epidemic in 2019-2020 season in Wuhan. Enhancing the surveillance of influenza could potentially facilitate better judgment about the real situation of COVID-19 pandemic, which could be hidden in massive influenza cases.

Funding Statement: Supported by the National Natural Science Foundation of China (81900097, 81903401), the Emergency Response Project of Hubei Science and Technology Department (2020FCA023), the National Science and Technology Major Project (2018ZX10101004), the Young Taishan Scholars Program of Shandong Province of China (tsqn20161046), the Shandong Province Higher Educational Young and Innovation Technology Supporting Program (2019KJL004), the Academic Promotion Program of Shandong First Medical University (2019RC010) and the Emergency Diagnostic and Therapeutic Center of Central China.

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: This study was approved by the Medical Ethics Committee, Zhongnan Hospital of Wuhan University (Clinical Ethical Approval No. 2020020). Written informed consent was obtained from the patients of respiratory symptoms group, and waived for the patients in other groups.

Keywords: Coronavirus Disease 2019; Influenza; Interference; Wuhan

Suggested Citation

Zhou, Xianlong and Ding, Guoyong and Shu, Ting and Fu, Shouzhi and Tong, Weiwei and Tu, Xiaopeng and Li, Shunqing and Wu, Di and Qiu, Yang and Yu, Jiangtao and Cao, Song and Jiang, Cheng and Ma, Haoli and Li, Shaoping and Xia, Jian and Zhao, Zhigang and Peng, Zhiyong and Yuan, Yufeng and Yu, Mingxia and Li, Yirong and Li, Zhiqiang and Xing, Weijia and Zhou, Xi and Zhou, Yan, The Outbreak of Coronavirus Disease 2019 Interfered with Influenza in Wuhan (3/12/2020). Available at SSRN: https://ssrn.com/abstract=3555239 or http://dx.doi.org/10.2139/ssrn.3555239

Xianlong Zhou

Wuhan University - Emergency Center

China

Guoyong Ding

Shandong First Medical University - School of Public Health

China

Ting Shu

Chinese Academy of Sciences (CAS) - State Key Laboratory of Virology

Wuhan, 430071
China

Shouzhi Fu

Wuhan Third Hospital - Department of Emergency & Intensive Care Unit

Wuhan
China

Weiwei Tong

Gennlife (Beijing) Biotechnology Co. Ltd.

Haidian, 100080
China

Xiaopeng Tu

Wuhan University - Emergency Center

China

Shunqing Li

Wuhan University - Emergency Center

China

Di Wu

Chinese Academy of Sciences (CAS) - State Key Lab of Virology

China

Yang Qiu

Chinese Academy of Sciences (CAS) - State Key Laboratory of Virology

Wuhan, 430071
China

Jiangtao Yu

Wuhan University - Emergency Center

China

Song Cao

Wuhan Third Hospital - Department of Emergency & Intensive Care Unit

Wuhan
China

Cheng Jiang

Wuhan University - Emergency Center

China

Haoli Ma

Wuhan University - Department of Biological Repositories

Wuhan
China

Shaoping Li

Wuhan University - Emergency Center

China

Jian Xia

Wuhan University - Emergency Center

China

Zhigang Zhao

Wuhan University - Emergency Center

China

Zhiyong Peng

Wuhan University - Department of Critical Care Medicine ( email )

Wuhan, 430071
China

Yufeng Yuan

Wuhan University - Department of Hepatobiliary and Pancreatic Surgery

Wuhan
China

Mingxia Yu

Wuhan University - Department of Clinical Laboratory

Wuhan, 430072
China

Yirong Li

Wuhan University - Department of Clinical Laboratory

Wuhan, 430072
China

Zhiqiang Li

Wuhan University - Department of Neurosurgery

Wuhan
China

Weijia Xing (Contact Author)

Chinese Academy of Sciences (CAS) - State Key Lab of Virology ( email )

China

Xi Zhou

Chinese Academy of Sciences (CAS) - State Key Lab of Virology ( email )

China

Yan Zhou

Wuhan University - Emergency Center ( email )

China

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