lancet-header
Preprints with The Lancet is part of SSRN´s First Look, a place where journals and other research experts identify content of interest prior to publication. These preprint papers are not peer-reviewed. Authors have either opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet, or submitted directly via SSRN. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These papers should not be used for clinical decision making or reporting of research to a lay audience without indicating that this is preliminary research that has not been peer-reviewed. For more information see the Comment published in The Lancet, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com

Is Co-Infection with Influenza Virus a Protective Factor of COVID-19?

19 Pages Posted: 5 May 2020

See all articles by Ge Wang

Ge Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Meng Xie

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Jingdong Ma

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Medicine and Health Management

Jialun Guan

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Yang Song

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Medicine and Health Management

Yue Wen

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Dan Fang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Muru Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

De-an Tian

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Peiyuan Li

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

More...

Abstract

Background: An emerging outbreak of COVID-19 has rapidly caused global pandemic. Few studies were reported on the incidence and role of influenza virus co-infection on COVID-19.

Methods: 273 hospitalized patients with COVID-19 and tests of influenza A/B virus were enrolled from February to March 2020 in Wuhan, China. Data on baseline characteristics, clinical manifestations and outcomes, laboratory findings were collected and analysed.

Findings: The incidence of influenza virus co-infection in patients with COVID-19 was 55·3% (151/273), with 48·5% (133/273) of influenza A and 6·6% (18/273) of influenza B, respectively. Influenza virus co-infection was significantly more common in non-critical group (60·5%, 115/190) than critical group (43·4%, 36/83; p=0·01). The fatality of COVID-19 in influenza group was 9·9% (15/151), while it was 23·8% (29/122) in non-influenza group (p=0·01). Accordingly, the incidence of critical type was higher in influenza group (p=0·01). Cox regression analysis revealed that co-infection with influenza virus had significant reduction of fatality than non-influenza group (OR 0·470, p<0·05). Other fatality indicators included age (p=0·02), sex (OR 3·626, p=0·00), and low lymphocytes (OR 2·368, p=0·04).

Interpretation: There is a high incidence of influenza virus co-infection in patients with COVID-19 in Wuhan, China. It seems like co-infection with influenza virus acts as a protective factor for COVID-19. The relationship between SARS-nCoV-2 and influenza virus co-infection warrants further studies.

Funding Statement: This study was supported by National Natural Science Foundation of China Grant (No. 81800493).

Declaration of Interests: All authors have no conflicts of interest to declare.

Ethics Approval Statement: The procedure was approved by the Institutional Ethics Board of Tongji Medical College. The follow-up was up to March 22, 2020.

Keywords: SARS-CoV-2; COVID-19; co-infection; influenza virus; severity; fatality

Suggested Citation

Wang, Ge and Xie, Meng and Ma, Jingdong and Guan, Jialun and Song, Yang and Wen, Yue and Fang, Dan and Wang, Muru and Tian, De-an and Li, Peiyuan, Is Co-Infection with Influenza Virus a Protective Factor of COVID-19? (4/14/2020). Available at SSRN: https://ssrn.com/abstract=3576904 or http://dx.doi.org/10.2139/ssrn.3576904

Ge Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Wuhan
China

Meng Xie

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Wuhan
China

Jingdong Ma

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Medicine and Health Management

13 Hangkong Road
Qiaokou District
Wuhan, 430030
China

Jialun Guan

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Wuhan
China

Yang Song

Huazhong University of Science and Technology (Formerly Tongi Medical University) - School of Medicine and Health Management

13 Hangkong Road
Qiaokou District
Wuhan, 430030
China

Yue Wen

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Wuhan
China

Dan Fang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Wuhan
China

Muru Wang

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Wuhan
China

De-an Tian

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology

Wuhan
China

Peiyuan Li (Contact Author)

Huazhong University of Science and Technology (Formerly Tongi Medical University) - Division of Gastroenterology ( email )

Wuhan
China

Click here to go to TheLancet.com

Paper statistics

Abstract Views
1,124
Downloads
111
PlumX Metrics