Abstract
We aimed to investigate the associations of previous influenza/URI with the susceptibility of COVID-19 patients compared to that of non-COVID-19 participants. A nationwide COVID-19 cohort database was collected by the Korea National Health Insurance Corporation. A total of 8,070 COVID-19 patients (1 January 2020 through 4 June 2020) were matched with 32,280 control participants. Severe COVID-19 morbidity was defined based on the treatment histories of the intensive care unit, invasive ventilation, and extracorporeal membrane oxygenation and death. The susceptibility/morbidity/mortality associated with prior histories of 1–14, 1–30, 1–90, 15–45, 15–90, and 31–90 days before COVID-19 onset were analyzed using conditional/unconditional logistic regression. Prior influenza infection was related to increased susceptibility to COVID-19 (adjusted odds ratio [95% confidence interval] = 3.07 [1.61–5.85] for 1–14 days and 1.91 [1.54–2.37] for 1–90 days). Prior URI was also associated with increased susceptibility to COVID-19 (6.95 [6.38–7.58] for 1–14 days, 4.99 [4.64–5.37] for 1–30 days, and 2.70 [2.55–2.86] for 1–90 days). COVID-19 morbidity was positively associated with influenza (3.64 [1.55–9.21] and 3.59 [1.42–9.05]) and URI (1.40 [1.11–1.78] and 1.28 [1.02–1.61]) at 1–14 days and 1–30 days, respectively. Overall, previous influenza/URI did not show an association with COVID-19 mortality. Previous influenza/URI histories were associated with increased COVID-19 susceptibility and morbidity. Our findings indicate why controlling influenza/URI is important during the COVID-19 pandemic.
Highlights
Abbreviations URI Upper respiratory infection COVID-19 Coronavirus disease 2019 SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 intensive care unit (ICU) Intensive care unit NHID-COVID Korea National Health Insurance Database Coronavirus Disease 2019 RT-PCR Real-time reverse transcriptase–polymerase chain reaction
Histories of influenza infections and URI in the previous [1,2,3,4,5,6,7,8,9,10,11,12,13,14] days, 1–30 days, and [1–90] days were more common in the COVID-19 patients than in the control participants
The COVID-19 susceptibility associated with previous histories of influenza infection or URI was consistent in all subgroups according to age, sex, income, Charlson comorbidity index (CCI) score, and histories of asthma, COPD, and hypertension (Figs. 2A–C, 3A–C, and Table S1)
Summary
Abbreviations URI Upper respiratory infection COVID-19 Coronavirus disease 2019 SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 ICU Intensive care unit NHID-COVID Korea National Health Insurance Database Coronavirus Disease 2019 RT-PCR Real-time reverse transcriptase–polymerase chain reaction. Recent studies have suggested the effects of influenza infection on the disease course of COVID-197,8. They reported severe COVID-19 outcomes in patients with coinfection with influenza[7,8,9]. Other studies reported a lower or similar rate of fatality of COVID-19 in coinfected patients with influenza than in single SARS-CoV-2-infected patients[10,11]. We hypothesized that recent infection histories of influenza/URI might be associated with SARS-CoV-2 positivity and COVID-19 morbidity/mortality. The primary object of this study was to evaluate the association between previous influenza/URI and susceptibility of COVID-19 patients compared to that of non-COVID-19 participants. The secondary objective was to estimate the relation between previous influenza/URI and morbidity/mortality in COVID-19 patients
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