healthy soch
With input from Dr Monica Vasudev
India
healthysoch
New Delhi, September 19, 2020 :
Flu, COVID-19 or Both? Don’t Overlook Co-Infection
- When a patient presents with acute respiratory symptoms this winter clinicians should consider three options: influenza, COVID-19, or co-infection as per CDC
- Co-infection with both has been documented in both case reports and case series.
- The only difference is loss of smell and loss of taste … [which] has not been reported with influenza virus infection
- Timothy Uyeki, MD, of the CDC elaborated on the largest case series of patients with influenza and SARS-CoV-2 co-infection: a series of 93 adult patients hospitalized with COVID-19 in Wuhan, Cina, where 49.5% had serologically diagnosed influenza infection.
- Co-infection, or even distinguishing SARS-CoV-2 from influenza, is particularly important because of the implications of treatment. For example, dexamethasone is recommended for severe COVID-19 infection in hospitalized patients, but corticosteroids actually prolong viral replication in influenza.
- Testing then becomes key in distinguishing the viruses
- There are several kinds of “multiplex” assays that received FDA emergency use authorization (EUA), including some that received EUAs. These are multiplex nucleic acid detection assays that can detect both influenza A and B viruses and SARS-CoV-2 simultaneously in respiratory specimens. Turnaround times for results within the lab vary quite a bit, from 20 minutes to 8 hours.
- Interestingly, patients at high risk for influenza complications, and who may benefit from early antiviral treatment, mirror those at higher risk for SARS-CoV-2: Adults ages 65 and older, Pregnant/postpartum women, People with underlying medical conditions — such as pulmonary, cardiac, and neurologic problems — and who are immunosuppressed or have a body mass index over 40 and Residents of nursing homes/chronic care facilities
- In addition, children ages 18 and younger receiving long-term aspirin therapy, as well as children under age 2, may also be considered for early antiviral treatment
Dr K K Aggarwal, President CMAAO
