2. Academic Validation
  3. Antiviral susceptibility of SARS-CoV-2 and influenza viruses from 3 co-infected pediatric patients

Antiviral susceptibility of SARS-CoV-2 and influenza viruses from 3 co-infected pediatric patients

  • Int J Infect Dis. 2024 Jun 27:146:107134. doi: 10.1016/j.ijid.2024.107134.
Emi Takashita 1,  Masataka Ichikawa 2,  Seiichiro Fujisaki 3,  Hiroko Morita 3,  Shiho Nagata 3,  Hideka Miura 3,  Shinji Watanabe 3,  Hideki Hasegawa 3,  Yoshihiro Kawaoka 4
Affiliations

Affiliations

  • 1 Research Center for Influenza and Respiratory Viruses, National Institute of Infectious Diseases, Tokyo, Japan. Electronic address: emitaka@niid.go.jp.
  • 2 Ichikawa Children's Clinic, Isehara, Kanagawa, Japan.
  • 3 Research Center for Influenza and Respiratory Viruses, National Institute of Infectious Diseases, Tokyo, Japan.
  • 4 Division of Virology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan; Research Center for Global Viral Diseases, National Center for Global Health and Medicine Research Institute, Tokyo, Japan; Department of Pathobiological Sciences, School of Veterinary Medicine, Influenza Research Institute, University of Wisconsin-Madison, Madison, WI, USA; Pandemic Preparedness, Infection, and Advanced Research Center, The University of Tokyo, Tokyo, Japan.
PMID: 38944411 DOI: 10.1016/j.ijid.2024.107134
Abstract

In Japan, influenza activity was low throughout the COVID-19 pandemic until the 2022-23 season, when the first influenza outbreak occurred since the 2020-21 season. In our influenza surveillance during the COVID-19 pandemic, co-infection with SARS-CoV-2 and Influenza Virus had not been detected; however, in January 2024, we identified three pediatric outpatients co-infected with these viruses: one with SARS-CoV-2 Omicron EG.5 sublineage HK.3 and influenza A(H3N2) and two with SARS-CoV-2 Omicron BA.2.86 sublineage JN.1.5 and influenza A(H1N1)pdm09. We evaluated the susceptibility of SARS-CoV-2 against RNA-dependent RNA polymerase inhibitors (remdesivir and molnupiravir) and 3C-like Protease Inhibitors (nirmatrelvir and ensitrelvir), and that of influenza viruses against neuraminidase inhibitors (oseltamivir, peramivir, zanamivir, and laninamivir) and the cap-dependent Endonuclease Inhibitor baloxavir. All viruses tested were susceptible to these Antiviral drugs and did not possess amino acid substitutions associated with reduced Antiviral susceptibility. The patients were treated with anti-influenza drugs and did not develop severe symptoms despite the co-infection. Since SARS-CoV-2 and influenza viruses continue to evolve, continuous monitoring of their circulation remains essential to assess public health measures and support clinical management.

Keywords

Antivirals; Co-infection; Influenza virus; SARS-CoV-2.

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