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The Outbreak of Coronavirus Disease 2019 Interfered with Influenza in Wuhan
22 Pages Posted: 25 Mar 2020More...
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
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