CoVid-19 and Influenza co-infection within North-West England: Flu-Rona – we won't ever find it if we don't look for it

Abstract

<b>Introduction:</b> During the 2021/22 influenza season, media outlets reported on potential influenza A/B and CoVid-19 coinfection, termed ‘<i>flu-rona</i>’. National guidelines (<i>Management of CAP in Adults, BTS, 2009</i>) suggest patients admitted with respiratory infection should undergo respiratory viral PCR (rvPCR) swabbing, severity dependent. We assessed: (1) UK teaching hospital seasonal rvPCR swab data for&nbsp;flu-rona&nbsp;(2) rvPCR swabbing behaviour in respiratory inpatients. <b>Methods:</b> (1) Collect data on all rvPCR swabs [Panther® Analyser] from 1/12/21 for 6 weeks with indication &amp; CoVid swab result within 7 days of rvPCR. (2) Assess rvPCR swabbing in respiratory ward admissions from 1/1/22 for 4 weeks. <b>Results:</b> (1) 234 patients underwent rvPCR testing, with none positive for influenza A/B. n=23 were positive for any virus. Haematology-oncology swabbed 136 patients (as per protocol). Of the remainder (n=98), 22.4% (n=22) had respiratory symptoms (RSx) – with one positive rvPCR swab. 10/98 were CoVid positive on concurrent testing, of whom 7 had RSx. (2) 117 patients were admitted to the respiratory ward, of whom 73 had RSx; of these n=53 CoVid positive with only 1 (2%) undergoing rvPCR swab, and 20 CoVid negative with only 2 (10%) undergoing rvPCR swabs (see table) <b>Conclusion:</b> We found no&nbsp;<i>flu-rona</i>&nbsp;and low rates of rvPCR swabbing in those with RSx despite national guidelines. While these data suggest rates of&nbsp;<i>flu-rona</i>&nbsp;are likely low, they highlight dangers of diagnostic blindness in the age of CoVid-19 and possible nihilistic beliefs regarding rvPCR testing in general