{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T15:49:08Z","timestamp":1776872948388,"version":"3.51.2"},"reference-count":6,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aimed to determine the impact of the COVID-19 pandemic on the overall prevalence and co-infection rates for COVID-19, influenza A\/B, and respiratory syncytial virus in a large national population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective review of 1,318,118 multi-component nucleic acid amplification tests for COVID-19, influenza A\/B, and RSV performed at Labcorp<jats:sup>\u00ae<\/jats:sup> sites from January 2018 to June 2023, comparing positivity rates and co-infection rates by age, sex, and seasonality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 2021\u20132023, 1,232 (0.10%) tested positive for COVID-19 and influenza A\/B, 366 (0.03%) tested positive for COVID-19 and RSV, 874 (0.07%) tested for influenza A\/B and RSV, and 13 (0.001%) tested positive for COVID-19, influenza A\/B, and RSV. RSV positivity rates were particularly higher in Q2 and Q3 of 2021 and in Q3 of 2022. Higher influenza A positivity proportions were found in Q4 of 2021 and again in Q2 and Q4 of 2022. Influenza B positivity had been minimal since the start of the pandemic, with a slight increase observed in Q2 of 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings highlight the need for adaptability in preparation for upper respiratory infection occurrences throughout the year as we adjust to the COVID-19 pandemic due to the observed changes in the seasonality of influenza and RSV. Our results highlight low co-infection rates and suggest heightened concerns for co-infections during peaks of COVID-19, influenza, and RSV, which may perhaps be reduced.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1297981","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T10:11:10Z","timestamp":1702289470000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Prevalence and trends in mono- and co-infection of COVID-19, influenza A\/B, and respiratory syncytial virus, January 2018\u2013June 2023"],"prefix":"10.3389","volume":"11","author":[{"given":"Min Kyung","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Alfego","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne E.","family":"Dale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1111\/IRV.12976","article-title":"Interactions among common non-SARS-CoV-2 respiratory viruses and influence of the COVID-19 pandemic on their circulation in new York City","volume":"16","author":"Yuan","year":"2022","journal-title":"Influenza Other Respir Viruses"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.15585\/MMWR.MM7029A1","article-title":"Changes in influenza and other respiratory virus activity during the COVID-19 pandemic \u2013 United States, 2020-2021","volume":"70","author":"Olsen","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"4528","DOI":"10.1002\/JMV.27857","article-title":"Respiratory virus circulation in children after relaxation of COVID-19 restrictions in fall 2021\u2014a nationwide register study in Finland","volume":"94","author":"Kuitunen","year":"2022","journal-title":"J Med Virol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"134","DOI":"10.3390\/IDR14010017","article-title":"The influence of COVID-19 on influenza and respiratory syncytial virus activities","volume":"14","author":"Mondal","year":"2022","journal-title":"Infect Dis Rep"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2085","DOI":"10.1001\/JAMA.2020.6266","article-title":"Rates of co-infection between SARS-CoV-2 and other respiratory pathogens","volume":"323","author":"Kim","year":"2020","journal-title":"JAMA"},{"key":"ref6","year":""}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1297981\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T10:11:12Z","timestamp":1702289472000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1297981\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,11]]},"references-count":6,"alternative-id":["10.3389\/fpubh.2023.1297981"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1297981","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,11]]},"article-number":"1297981"}}