{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:46:48Z","timestamp":1792014408681,"version":"4.4.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Public Health England as part of the routine functions of surveillance and control of communicable diseases"},{"name":"National Infection Service, Immunisation and Countermeasures Division"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The impact of SARS-CoV-2 alongside influenza is a major concern in the northern hemisphere as winter approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Test data for influenza and SARS-CoV-2 from national surveillance systems between 20 January 2020 and 25 April 2020 were used to estimate influenza infection on the risk of SARS-CoV-2 infection. A test-negative design was used to assess the odds of SARS-CoV-2 in those who tested positive for influenza compared with those who tested negative. The severity of SARS-CoV-2 was also assessed using univariable and multivariable analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The risk of testing positive for SARS-CoV-2 was 58% lower among influenza-positive cases and patients with a coinfection had a risk of death of 5.92 (95% confidence interval: 3.21\u201310.91) times greater than among those with neither influenza nor SARS-CoV-2. The odds of ventilator use or death and intensive care unit admission or death were greatest among coinfected patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Coinfection of these viruses could have a significant impact on morbidity, mortality and health-service demand.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ije\/dyab081","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T09:47:15Z","timestamp":1618220835000},"page":"1124-1133","source":"Crossref","is-referenced-by-count":184,"title":["Interactions between SARS-CoV-2 and influenza, and the impact of coinfection on disease severity: a test-negative design"],"prefix":"10.1093","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3999-6461","authenticated-orcid":false,"given":"Julia","family":"Stowe","sequence":"first","affiliation":[{"name":"Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Tessier","sequence":"additional","affiliation":[{"name":"Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Zhao","sequence":"additional","affiliation":[{"name":"Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Guy","sequence":"additional","affiliation":[{"name":"Healthcare Associated Infections and Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berit","family":"Muller-Pebody","sequence":"additional","affiliation":[{"name":"Healthcare Associated Infections and Antimicrobial Resistance Division, National Infection Service, Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Zambon","sequence":"additional","affiliation":[{"name":"Virus Reference Department, National Infection Service, Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Andrews","sequence":"additional","affiliation":[{"name":"Statistics, Modelling and Economics Department, National Infection Service, Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Ramsay","sequence":"additional","affiliation":[{"name":"Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Lopez Bernal","sequence":"additional","affiliation":[{"name":"Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,3]]},"reference":[{"key":"2021083121321350200_dyab081-B1","doi-asserted-by":"crossref","first-page":"2489","DOI":"10.1002\/jmv.26167","article-title":"Are co-infections with COVID-19 and Influenza low or underreported? 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