Respiratory Illness Resurgence: Coinfections Involving COVID-19

October 3, 2022

The World Health Organization recently advised that countries should monitor the co-circulation of influenza and SARS-CoV-2 viruses. They also urge clinicians to consider influenza in differential diagnosis, especially for high-risk groups for influenza, and test and treat according to national guidance.

Various hygiene and physical distancing measures taken to mitigate the transmission of COVID-19 have likely played a role in reducing the typical spread of influenza (flu). However, now, loosened COVID-19 guidelines and lessened mask-wearing leave us susceptible to pathogens that we’ve had less exposure to during the pandemic.

The data we are observing in Europe and Australia supports the prediction that the flu may return with a vengeance this winter. Hospital admissions for COVID-19 patients have jumped 48% in England, and the 14-day average of cases have increased in Germany (+90%), Italy (+83%), and France (+71%).

Australia had its most severe flu season in five years. Not only was it severe—it came on surprisingly fast. Most cases reported in 2022 have been influenza A, with H3N2 as the main subvariant. Past research posits that H3N2 causes more severe illness than typical seasonal flu

Further, we’re seeing a rise in several respiratory viruses such as respiratory syncytial virus (RSV) and human rhinoviruses and enteroviruses (D68) — especially in children and adolescents. These early indicators suggest that 2022 may be the year that “normal” respiratory viruses come back in full force, potentially causing severe coinfections involving COVID-19.

The issue with the circulation of multiple respiratory viruses is that the transmission and clinical symptoms share similarities. For example, the most common symptoms of COVID-19 are fever, dry cough, labored breathing, headache, muscle pain, and fatigue, resembling the symptoms of influenza A/B, respiratory syncytial virus (RSV), adenovirus, parainfluenza, human metapneumovirus, and human rhinovirus/enterovirus. Therefore, making an accurate diagnosis without highly sensitive and specific testing can be difficult.

Rapid detection of the most common causes of respiratory infection is important for several reasons. These include determining isolation protocols, avoiding unnecessary use of medications, and starting a regimen for recovery.

Flow Health’s Respiratory Pathogen Panel is a qualitative, multiplexed, real-time PCR assay. The panel can simultaneously detect multiple pathogens directly from respiratory specimens within a single swab sample. 

The presence of viral or bacterial infection combined with COVID-19 poses a serious threat to our health, particularly those in high-risk groups. Considering the similarities in how respiratory illnesses spread and their symptoms, proper testing to provide an early diagnosis and treatment of these infections is critical to ensure positive health outcomes.

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