Author:
Chang De,Lin Mingui,Song Ning,Zhu Zhantao,Gao Jing,Li Shujun,Liu Hongmei,Liu DeZhi,Zhang Yu,Sun Wenkui,Zhou Xuan,Yang Bin,Li Yongjun,Wang Lili,Xiao Zhiqing,Li Kailong,Xing Lihua,Xie Lixin,Sharma Lokesh
Abstract
Abstract
Background
The emergence of COVID-19 and the implementation of preventive measures and behavioral changes have led to a significant decrease in the prevalence of other respiratory viruses. However, the manner in which seasonal viruses will reemerge in the absence of COVID-19-related restrictions remains unknown.
Methods
Patients presenting with influenza-like illness in two hospitals in Beijing were subjected to testing for COVID-19, influenza A, and influenza B to determine the causative agent for viral infections. The prevalence of influenza B across China was confirmed using data from the Centers for Disease Control, China (China CDC). Clinical characteristics, laboratory findings, imaging results, and mortality data were collected for a cohort of 70 hospitalized patients with confirmed influenza B from 9 hospitals across China.
Results
Starting from October 2021, a substantial increase in the number of patients visiting the designated fever clinics in Beijing was observed, with this trend continuing until January 2022. COVID-19 tests conducted on these patients yielded negative results, while the positivity rate for influenza rose from approximately 8% in October 2021 to over 40% by late January 2022. The cases started to decline after this peak. Data from China CDC confirmed that influenza B is a major pathogen during the season. Sequencing of the viral strain revealed the presence of the Victoria-like lineage of the influenza B strain, with minor variations from the Florida/39/2018 strain. Analysis of the hospitalized patients' characteristics indicated that severe cases were relatively more prevalent among younger individuals, with an average age of 40.9 ± 24.1 years. Among the seven patients who succumbed to influenza, the average age was 30 ± 30.1 years. These patients exhibited secondary infections involving either bacterial or fungal pathogens and displayed elevated levels of cell death markers (such as LDH) and coagulation pathway markers (D-dimer).
Conclusion
Influenza B represents a significant infection threat and can lead to substantial morbidity and mortality, particularly among young patients. To mitigate morbidity and mortality rates, it is imperative to implement appropriate vaccination and other preventive strategies.
Funder
The National Key Research and Development Program of China
Publisher
Springer Science and Business Media LLC
Subject
Infectious Diseases,Virology
Reference16 articles.
1. Chen J-M, Chen Y-Q. China can prepare to end its zero-COVID policy. Nat Med. 2022;28(6):1104–5.
2. Centers of Disease Control, China. Summary of Influenza Epidemic Situation in China (as of January 2, 2022) https://ivdc.chinacdc.cn/cnic/zyzx/lgzb/202201/t20220107_255923.htm. Accessed July 19 2022 2022
3. Elo IT, Luck A, Stokes AC, Hempstead K, Xie W, Preston SH. Evaluation of age patterns of COVID-19 mortality by race and ethnicity from march 2020 to October 2021 in the US. JAMA Netw Open. 2022;5:e2212686–e2212686.
4. Itaya T, Furuse Y, Jindai K. Does COVID-19 infection impact on the trend of seasonal influenza infection? 11 countries and regions, from 2014 to 2020. Int J Infect Dis. 2020;97:78–80.
5. Iuliano AD, Roguski KM, Chang HH, Muscatello DJ, Palekar R, Tempia S, Cohen C, Gran JM, Schanzer D, Cowling BJ. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. The Lancet. 2018;391:1285–300.