There is a risk of co-infection of new crown flu in this winter. A


reporter from the Beijing News combed and found multiple cases of co-infection; Beijing has increased its nucleic acid testing capabilities; experts say co-infection does not necessarily aggravate the condition

  Recently, Zhong Nanshan, an academician of the Chinese Academy of Engineering, stated in public that there have been 4 cases of both influenza and COVID-19.

The Beijing Municipal Center for Disease Control and Prevention also issued a reminder that there is a risk of overlapping respiratory infections such as the new crown epidemic and influenza in this autumn and winter.

The reporter learned that in January this year, patients with co-infection of the new crown and influenza A have appeared in my country, and co-infection cases have also appeared in Japan, Spain, Iran and other countries.

Experts said that this phenomenon is very common clinically, and co-infection does not necessarily aggravate the disease. Ordinary citizens can effectively prevent the new crown and influenza as long as they pay attention to wearing masks correctly, gathering less, and washing hands frequently.

  According to reports, the symptoms of influenza and new crown infection are very similar, including fever, sore throat, body pain, vomiting, diarrhea, etc. Heavier patients will have difficulty breathing and lung inflammation, which is difficult to distinguish.

Compared with other respiratory diseases, new coronary pneumonia does not have outstanding specific manifestations.

The only way to distinguish between COVID-19 and influenza is nucleic acid testing.

  Follow-up 1

  Zhang Wenhong, director of the Department of Infectious Diseases at Huashan Hospital, Fudan University, said that co-infections are very common in respiratory diseases, but they have not been tested in the past.

  When will there be cases of co-infection in my country?

  In January this year, I received a case of simultaneous infection with influenza A and new crown

  Recently, at the first China Health Technology Innovation and Development Conference held in Shenzhen, Zhong Nanshan, an academician of the Chinese Academy of Engineering, mentioned that among the feedback received so far, there have been 4 cases of both influenza and new crown.

With the advent of winter, influenza enters an outbreak period, and patients with both influenza and new crown will appear in the future.

  The reporter consulted the professional literature and found that as early as January this year, Chinese medical institutions had received cases of concurrent infection with influenza A and COVID-19.

  On January 23 this year, the China-Japan Friendship Hospital admitted a male patient.

The 69-year-old man had visited Wuhan from December 18, 2019 to January 22, 2020. He began to develop symptoms on January 23 and was treated at the China-Japan Friendship Hospital.

As the patient had travel history in Wuhan, he was isolated as a suspected case.

The patient received a total of four new coronavirus nasopharyngeal swab tests and two sputum sample tests, all of which were negative. In the previous test, the patient was diagnosed as positive for influenza A.

When admitted to the hospital for bronchoscopy, the new coronavirus was detected in his alveolar lavage fluid.

  Co-infection cases have also occurred in other countries.

  From February to March this year, Iranian researchers selected four patients with symptoms of pneumonia and suspected of being infected with the new crown from the local hospital. They tested their nasopharyngeal and throat swabs and found that all four were co-infected with the new crown and A stream.

  In April this year, a 57-year-old male patient was admitted to Yokkaichi Municipal Hospital in Japan. Previously, the patient was tested positive for influenza A and was transferred to the hospital because of fever. Subsequently, the patient’s nasopharyngeal swab tested positive for the new coronavirus .

  In May of this year, researchers in Barcelona, ​​Spain, introduced four patients with co-infection of COVID-19 and influenza in a local hospital. They were 81, 53 and 78 years old. They all had a history of hypertension. Two had diabetes and two had a history of hypertension. Kidney disease.

All 4 people saw a doctor because of dry cough, fever and difficulty breathing.

Among them, 2 people were co-infected with COVID-19 and influenza A, 1 was co-infected with COVID-19 and B, and 1 was co-infected with COVID-19 and A and B.

  In addition to flu, patients may also be infected with other pathogens.

  In April this year, researchers from Wuhan University People’s Hospital and Wuhan University School of Health revealed that from December 1 last year to January 16 this year, two children in a hospital in Wuhan were diagnosed with the new crown virus, and one of them was at the same time. He was infected with human respiratory syncytial virus and human metapneumovirus, and another person was infected with both human metapneumovirus and Mycoplasma pneumonia.

  In an interview with the media, Zhang Wenhong, director of the Department of Infectious Diseases at Huashan Hospital affiliated to Fudan University, said that co-infections are very common in respiratory diseases, but they have not been tested in the past.

  Follow-up 2

  The severity of a patient's illness mainly depends on the degree of infection and personal physique. At present, whether they are infected with influenza or new crown, most of them are mild.

  Will the condition of co-infected people get worse?

  The development of co-infected patients varies

  The reporter found that the same occurrence of co-infection, the development of patients is not the same.

  In the case of co-infection reported by the China-Japan Friendship Hospital, there had been persistent fever and increased dyspnea. The chest radiograph showed diffuse exudation of both lungs.

After 4 days of hospitalization, oxygenation and chest X-ray showed improvement, and he was transferred to a designated hospital for further intensive care treatment.

  In the case of co-infection reported in Yokkaichi, Japan, hypoxemia and persistent fever occurred after hospitalization, and symptoms improved on the seventh day of hospitalization. Four weeks later, the patient reached the discharge standard for confirmed cases of new coronary pneumonia in Japan and was discharged home.

  Among the 4 patients in Barcelona, ​​patients who were co-infected with the new crown, influenza A, and influenza B were discharged 48 hours later without treatment or complications.

The other three patients need supportive treatment such as tracheal intubation and mechanical ventilation.

  Among the two cases of children in Wuhan, one was diagnosed with severe pneumonia due to ground glass shadows in the lungs and low blood oxygen saturation (70%). He was admitted to the ICU for treatment and was discharged smoothly after 2 weeks without residual symptoms.

Another person was discharged after 11 days of antibiotic treatment and supportive care.

  "From the characteristics of the new coronavirus itself, compared with a single infection, it cannot be said that there is no possibility of aggravation of the co-infection. The new coronavirus is different from the influenza virus. The latter mainly damages the lungs and heart of the human body. All tissues and organs of the human body, blood coagulation function, and endothelium can have an impact." Jia Ming, chief physician of the ICU of Cardiac Surgery of Beijing Anzhen Hospital, who once supported Wuhan, said, "But this is just a possibility. There is no specific science yet. Research. The severity of a patient's condition depends mainly on the degree of infection and personal physique. From now on, whether you are infected with influenza or the new crown, most of them are mildly ill, so there is no need to panic."

  Follow-up 3

  Ordinary citizens need to strengthen their protection. Scientifically and correctly wearing masks is one of the important measures to prevent respiratory infectious diseases. Do not pull masks to the jaw and neck for the convenience of talking and eating.

  How to distinguish between COVID-19 and influenza infection?

  The only method is nucleic acid testing; Beijing is increasing its nucleic acid testing capabilities

  According to Jia Ming, from the perspective of symptoms, the symptoms of influenza and new crown infection are very similar, including fever, sore throat, body pain, vomiting, diarrhea, etc. Heavier patients will have difficulty breathing and lung inflammation, which is difficult to use as a measure The basis of distinction.

  The aforementioned series of co-infected individuals also showed similar symptoms.

For example, two cases of children with new coronary pneumonia developed high fever (40°C), coughing, wheezing, and vomiting, and one had lung shadows; the elderly male cases confirmed by the China-Japan Friendship Hospital had fever and dry cough; many severe patients had breathed Difficulty, receiving treatment in ICU.

  Several respiratory experts told reporters that compared with other respiratory diseases, new coronary pneumonia does not have outstanding specific manifestations.

The only way to distinguish between COVID-19 and influenza is nucleic acid testing.

  The research team of the China-Japan Friendship Hospital pointed out that multiple nucleic acid tests of the co-infected cases in the hospital were negative, which means that the sensitivity of the new crown detection of upper respiratory tract samples may not be enough.

In clinically highly suspected cases, appropriate other testing is necessary.

  Guo Jun, deputy chief physician of the Department of Respiratory and Critical Care Medicine at Beijing Tsinghua Chang Gung Memorial Hospital, analyzed that for medical institutions, co-infection cases mean that the two diseases are superimposed, which will increase the workload.

In previous years, patients with fever only needed to be screened for influenza in the hospital. Now the new coronavirus nucleic acid test has been added. The test volume is larger, the waiting time is longer, and the pressure will increase.

  The reporter learned that in order to prepare for the possible epidemic in autumn and winter, Beijing is increasing its nucleic acid testing capabilities. A hospital staff who is undergoing renovation of the infection building revealed that the hospital has vacated a new space as a testing laboratory and its nucleic acid testing capabilities To reach more than 10,000 copies.

  The Beijing Municipal Center for Disease Control and Prevention recently issued a reminder that in view of the risk of the new crown epidemic and influenza and other respiratory infectious diseases in this autumn and winter, it is recommended that medical personnel, including clinical rescuers, public health personnel, and health and quarantine personnel, be influenza vaccines. Priority vaccination objects.

Ordinary citizens need to strengthen protection. Scientifically and correctly wearing masks is one of the important measures to prevent respiratory infectious diseases. Do not pull the mask to the jaw, neck, etc. for the convenience of talking and eating, and do not hang the mask on the arm to contaminate the mask. The inner layer and the mask should be replaced in time when it gets wet or dirty.

  Beijing News reporter Dai Xuan