2. Academic Validation
  3. Interaction and antiviral treatment of coinfection between SARS-CoV-2 and influenza in vitro

Interaction and antiviral treatment of coinfection between SARS-CoV-2 and influenza in vitro

  • Virus Res. 2024 Apr 18:345:199371. doi: 10.1016/j.virusres.2024.199371.
Danlei Liu 1,  Ka-Yi Leung 2,  Hoi-Yan Lam 2,  Ruiqi Zhang 1,  Yujing Fan 1,  Xiaochun Xie 1,  Kwok-Hung Chan 3,  Ivan Fan-Ngai Hung 4
Affiliations

Affiliations

  • 1 Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
  • 2 Department of Microbiology, Li Ka Shing faculty of Medicine, University of Hong Kong, Hong Kong, China.
  • 3 Department of Microbiology, Li Ka Shing faculty of Medicine, University of Hong Kong, Hong Kong, China; State Key Laboratory for Emerging Infectious Diseases, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China; Carol Yu Centre for Infection, Li Ka Shing faculty of Medicine, University of Hong Kong, Hong Kong, China.
  • 4 Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China; State Key Laboratory for Emerging Infectious Diseases, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China; Carol Yu Centre for Infection, Li Ka Shing faculty of Medicine, University of Hong Kong, Hong Kong, China. Electronic address: ivanhung@hku.hk.
PMID: 38621598 DOI: 10.1016/j.virusres.2024.199371
Abstract

Background: The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has lasted for three years. Coinfection with seasonal influenza may occur resulting in more severe diseases. The interaction between these two viruses for Infection and the effect of Antiviral treatment remains unclear.

Methods: A SARS-CoV-2 and influenza H1N1 coinfection model on Calu-3 cell line was established, upon which the simultaneous and sequential coinfection was evaluated by comparing the viral load. The efficacy of molnupiravir and baloxavir against individual virus and coinfection were also studied.

Results: The replication of SARS-CoV-2 was significantly interfered when the Influenza Virus was infected simultaneously or in advance (p < 0.05). On the contrary, the replication of the Influenza Virus was not affected by the SARS-CoV-2. Molnupiravir monotherapy had significant inhibitory effect on SARS-CoV-2 when the concentration reached to 6.25 μM but did not show any significant anti-influenza activity. Baloxavir was effective against influenza within the dosage range and showed significant effect of anti-SARS-CoV-2 at 16 μM. In the treatment of coinfection, molnupiravir had significant effect for SARS-CoV-2 from 6.25 μM to 100 μM and inhibited H1N1 at 100 μM (p < 0.05). The tested dosage range of baloxavir can inhibit H1N1 significantly (p < 0.05), while at the highest concentration of baloxavir did not further inhibit SARS-CoV-2, and the replication of SARS-CoV-2 significantly increased in lower concentrations. Combination treatment can effectively inhibit influenza H1N1 and SARS-CoV-2 replication during coinfection. Compared with molnupiravir or baloxavir monotherapy, combination therapy was more effective in less dosage to inhibit the replication of both viruses.

Conclusions: In coinfection, the replication of SARS-CoV-2 would be interfered by influenza H1N1. Compared with molnupiravir or baloxavir monotherapy, treatment with a combination of molnupiravir and baloxavir should be considered for early treatment in patients with SARS-CoV-2 and influenza coinfection.

Keywords

Antiviral; Baloxavir; Coinfection; Influenza; Molnupiravir; SARS-CoV-2.

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