Influenza And New Omicron, Can Aggravate The Patient's Condition?

With the advent of the flu boom in southern China, the topic of flu and Omicron Covid co-infection has gradually entered the public eye. In May, Jiang Shibo, a virologist at Fudan University, introduced the "flu-new coronavirus syndrome" (Flucovid) in a short commentary, which refers to patients who have symptoms of both influenza and new coronavirus infection. 

Through related research and animal model analysis, researchers found that co-infection of influenza A virus and new coronavirus may lead to an increase in the severe rate of new coronary, and even cause people to suffer from more serious diseases. 

Recently, the proportion of influenza cases in the south is much higher than in the same period of 2019-2022. Many hospitals in Guangdong, Fujian, Guangxi, Jiangxi, Hainan, and other places have seen a sudden increase in the number of fever clinic admissions. The flu is quietly under the cover of the Omicron Covid attack.

The Omicron Covid pandemic has not stopped, and it has been hit head-on by seasonal influenza. The Omicron Covid-influenza syndrome is brought about by the double virus attack. How should we take preventive and control measures? 

 What happens when influenza is co-infected with the new coronavirus? As early as January 2 this year, Israel's "New News" reported the first case of "influenza-Omicron Covid syndrome", that is, a case of simultaneous infection with the new coronavirus and influenza virus. She was an unvaccinated young pregnant woman in Israel. . The sudden outbreak of influenza in many places in southern my country this summer brought the topic of Omicron Covid-flu co-infection to the forefront again. 

So, what is a flu-coronavirus syndrome?

Under the Omicron Covid pandemic, the influenza virus has not stopped. In the first half of this year in southern my country, there was a large-scale spread, so a term called "Flurona" (flu-Omicron Covid infection syndrome) appeared frequently on major news platforms. "Flurona" is very similar to the earlier "Delmicron" (a recombinant strain of Delta and Omicron), which makes it easy to think that Flurona is the name of a recombinant virus-like Delmicron, but it is not.

On May 19, Fudan University virologist Jiang Shibo and other scholars published a short review in J Med Virol, "Disease of influenza virus and SARS-CoV-2 coinfection: Flurona or Flucovid? , analyzed the characteristics of influenza-Omicron coinfection. In order to avoid misunderstanding, Jiang Shibo et al. proposed a more accurate term to replace Flurona, namely Flucovid (influenza-Omicron Covid syndrome), indicating that patients have symptoms of both influenza and new coronavirus infection.

Next, we analyze Jiang Shibo's article from the two aspects of the patient's symptoms and virus infection rate. From the clinical manifestations of the patients, the symptoms of influenza and Omicro Covids are similar, such as fever, dry cough, fatigue, headache, shortness of breath, loss of taste or smell, etc. However, patients with flu and Omicro Covid co-infection will not have cold symptoms (such as sneezing, runny nose, nasal congestion, sore throat, low back pain, etc.), and the patient's nucleic acid test results are positive for influenza and Omicro Covid.

Comparison of the main symptoms of the Omicro Covid, influenza and colds From the perspective of the virus infection rate, Jiang Shibo and other scholars pointed out in this paper that according to an analysis of 54 related literatures, the Omicro Covid positive patients were co-infected with influenza virus The overall proportion was 0.7%; another 18-month study of 17,011 adults infected with the new coronavirus showed a 1.3% influenza virus co-infection rate.

What is the risk of co-infection with flu-coronavirus syndrome?

Some co-infected patients may have undetectable influenza virus at the same time when the Omicron Covid is diagnosed (the incubation period and virus shedding period of influenza are both shorter than those of the Omicron Covid), so the actual co-infection rate may be much higher than the above values.

In the children group, the proportion of influenza-Omicron Covid co-infection (3.2%) was significantly higher than that of adult patients (0.3%), indicating that children are more susceptible to influenza-Omicron Covid co-infection. More importantly, among the critically ill patients with new coronary pneumonia, the proportion of influenza-Omicron Covid co-infection was 2.2%, which was higher than that of patients infected with new coronary pneumonia alone (0.6%), indicating that co-infection with influenza virus may increase the severity of new coronary pneumonia.

In addition, animal studies have shown that co-infection results in more severe weight loss and pulmonary inflammatory damage, as well as increased tissue cytokine/chemokine expression levels, compared with influenza A or SARS-CoV-2 infection alone.

Therefore, co-infection of influenza and Omicron Covids may also lead to more severe diseases in humans. In summary, the researchers came to the following conclusions: 1. The infection rate of influenza-Omicron Covid co-infection is higher in vulnerable groups of children; 2. Patients infected with influenza and Omicron Covid at the same time will cause the patient's symptoms to worsen and even suffer from other serious diseases disease. At present, abnormal seasonal influenza occurs in the southern part of my country in summer. The global tension caused by Omicron BA.4/5 has not yet subsided, and there has been such an abnormal influenza epidemic. How should we respond?

The Southern Influenza virus is raging, how can we prevent and control it?

Let us first review the current situation of the recent influenza outbreak in southern my country. According to the data of the National Influenza Center, the influenza virus in many southern provinces has entered a high summer season. In previous years, the peak influenza season should have been in autumn and winter, but recently it has broken out abnormally in 7 southern provinces.

% of influenza-like cases reported by sentinel hospitals in southern China provinces in 2019-2022

According to the data of the National Center for Disease Control and Prevention (CDC), the positive rate of influenza virus detection in southern provinces has continued to rise, and the proportion of cases is much higher than that of the same period in 2019-2022. ) as the main. The Omicron Covid epidemic is not over yet, and when many people are nervous about "Omicron BA.4/5", "unusual summer flu epidemics" occurred in many southern provinces. It is inevitable that people will think of flu-Omicron Covid co-infection, which may cause 1+1>2 consequences.

To this end, Jiang Shibo and others stated in their paper that it is recommended to treat influenza-Omicron Covid syndrome through the combined use of anti-influenza drugs and anti-Omicron Covid drugs like cistanche tubulosa anti-covid extract powder. In order to prevent influenza-Omicron Covid syndrome, it is recommended to pay attention to the vaccination of influenza vaccine and Omicron Covid vaccine (the interval between two vaccinations should be greater than 14 days).

It is worth mentioning that at present, scientists around the world are accelerating the development of an Omicron Covid universal vaccine, a vaccine that can resist multiple new coronavirus strains, and perhaps it can combat influenza-Omicron Covid syndrome. In fact, pharmaceutical companies are already starting to develop new vaccines that can be used not only against influenza but also against the new coronavirus. For example, the pharmaceutical company Novavax previously announced a generic vaccine against both the new coronavirus and the influenza virus. The vaccine NVX-Cov2373 has entered clinical phase 1/2. Perhaps in the near future, we can prevent multiple epidemics at the same time with the help of a universal vaccine, such as the Omicron Covid, influenza virus, etc.

At present, we still need to strengthen physical protection measures and get the Omicro Covid and influenza vaccine as soon as possible to fight the current pandemic.