The influenza and SARS-CoV-2 viruses once again are in cocirculation. Following is a topline look at the NIH guideline on their simultaneous management.
The National Institutes of Health has published an update to its guidance on seasonal influenza to address vaccination, testing, and treatment when the influenza and SARS-CoV-2 viruses are cocirculating.
This section of the guideline includes:
Following is a topline summary of the guideline in a short slide show.
Influenza Vaccination. People infected with SARS-CoV-2 who are not moderately/severely ill (including those who are asymptomatic) should seek influenza vaccination when they no longer require isolation.
Diagnosis Requires Testing. Only testing can distinguish between SARS-CoV-2 and influenza virus infections and identify SARS-CoV-2 and influenza virus coinfection.
Test for Both Influenza and COVID-19 Viruses. The CDC Panel recommends influenza testing in addition to SARS-CoV-2 testing in outpatients with acute respiratory illness if the results will change the clinical management strategy for the patient (eg, administering antiviral treatment for influenza) (BIII).
Test for Other Pathogens. Clinicians should consider testing patients for other pathogens based on their specific clinical circumstances.
Clinical Presentation of Influenza vs COVID-19. Signs/symptoms of uncomplicated, clinically mild
influenza overlap with those of mild COVID-19. Ageusia and anosmia can occur with both diseases
but are more common with COVID-19.
Complications of Influenza vs COVID-19. Complications of the 2 viruses can be similar, but onset of severe disease/complications in influenza typically occurs within 1 week of illness onset vs during the second week of illness for COVID-19.
Multiplex Testing Available for Flu/COVID-19. Several multiplex molecular assays and multiplex antigen assays that detect SARS-CoV-2 and influenza A and B viruses have received FDA EUA or De Novo classifications.
Antiviral Treatment of Influenza. The treatment of influenza is the same in all patients regardless of SARS-CoV-2 coinfection (AIII).
Oseltamavir and SARS-CoV-2. Oseltamivir has no activity against SARS-CoV-2 or known interactions with remdesivir or other therapeutics for COVID-19.
When to Stop Antivirals for Influenza. Antiviral treatment of influenza can be stopped when influenza has been ruled out by results of nucleic acid detection assay in upper respiratory tract specimens for nonintubated patients and in both upper and lower respiratory tract specimens for intubated patients.