SARS-CoV-2 co-infection with influenza virus, respiratory syncytial virus or adenovirus

As public health restrictions are lifted, respiratory virus co-infections are more likely to occur in future winters. The marked increase in risk among patients with concomitant infection has several implications for the policy. First, our results provide further support for vaccination against both SARS-CoV-2 and influenza virus. Second, they suggest that testing for influenza virus is important in hospitalized patients with COVID-19 to identify patients at risk and a cohort of patients who may have different responses to immunomodulatory and antiviral therapy.

All authors declare support from the National Institute for Health Research (NIHR), Medical Research Council (MRC), NIHR Health Protection Unit (HPRU) in Emerging and Zoonotic Infections at the University of Liverpool, NIHR HPRU in Respiratory Infections at Imperial College London, NIHR Biomedical Research Center at Imperial College London and the NIHR Clinical Research Network. JKB and ABD report on grants from the UK Department of Health and Social Care (DHSC) during the conduct of the study and grants from the Wellcome Trust. PJMO reports personal fees from consulting firms (ie GlaxoSmithKline, Janssen, Bavarian Nordic, Pfizer and Cepheid) and for the European Respiratory Society; grants from MRC, MRC Global Challenge Research Fund, EU, NIHR Biomedical Research Center, MRC – GlaxoSmithKline, Wellcome Trust and NIHR (HPRU in Respiratory Infection); and is an NIHR senior investigator, not related to this correspondence. PJMO’s role as president of the British Society for Immunology was unpaid, but travel and accommodation at some meetings were paid for by the company. JKB reports grants from MRC. MGS reports grants from DHSC, NIHR UK, MRC, HPRU in Emerging and Zoonotic Infections and the University of Liverpool during the course of the study and is chair of the Scientific Advisory Committee and a minority shareholder in Integrum Scientific, unrelated to this Correspondence. GHG, MGS and JKB contributed equally. ISARIC4C investigators are listed in the appendix.