Essam Mekhaiel, MD
Attending- Interventional Pulmonology and Critical Care
Advocate Christ Medical Center, United States
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Title: Seasonal Influenza in the Wake of the Novel Coronavirus Pandemic: An Example of Viral Interference?
Introduction: The Influenza Virus Is an Important Contributor to the Morbidity and Mortality in Hospitalized Patients. This Virus Species Affects the Population in North America on a Traditionally Seasonal Basis. Anecdotally, There Have Been Fewer Local Cases of Influenza in the Setting of the novel SARS-CoV-2 (COVID-19) Pandemic. In This Study We Seek to Assess the Epidemiology of Influenza Virus Species During the 2020-2021 Season at a Large Tertiary Care Community Hospital.
Methods: The Total Number of Adult Patients 18 Years and Older with Positive Influenza Result Were Identified from the Hospital Influenza Surveillance Data. Subgroup Analysis Was Performed by Identifying Adults 18 Years and Older with a Positive Result on Respiratory Pathogen Panel (RPPNL) Performed at the Facility During the Study Period.
Results: In the 2018-2019 Season (S1), a Total of 3076 Tests for Influenza Virus Were Performed, with 582 Testing Positive for Influenza A, and 35 Testing Positive for Influenza B (18.6% of Tests Positive). In the 2019-2020 Season (S2) 8288 Tests Were Performed with 1476 Testing Positive for Influenza B, and 1043 Testing Positive for Influenza B (27.5% of Tests Positive) . There Were 974 Tests Performed in the 2020-2021 Season (S3), but 0 Positive Cases of Influenza A or B Identified (0% of Tests Positive). Rhinovirus Accounted for 57% of All Positive RPPNL Results in P3, in Contrast to 19.6% and 22.9% During P1 and P2, Respectively.
Conclusions: There Were No Cases of Influenza Virus Identified at This Facility During S3. Both This Study, and National Data from the CDC, Show Suppression of Normal Cyclical Trends of Influenza, and an Uncharacteristic Rise in Rhinovirus Infections, in the Background of the COVID-19 Pandemic. Virus-virus Interaction Is a Possible Contributory Factor. Viral Interference Between Influenza A and Rhinovirus Has Been Well Demonstrated, with Rhinovirus Driving Both Protective Mechanisms Against Influenza A at the Host Level and Asynchronous Circulation of Influenza A on the Environmental Level. This Lends Credibility to the Concept of an Indirect Interaction Between the Influenza Virus and COVID-19. If Temporal Displacement of Influenza Infections Occurs, It Is of Importance for the Health Care Community to Allocate Resources and Advise Accordingly.