Respiratory Pathogen Coinfection During Intersecting COVID-19 and Influenza Epidemics

Respiratory pathogen coinfections pose significant challenges to global public health, particularly regarding the intersecting epidemics of COVID-19 and influenza. This study investigated the incidences of respiratory infectious pathogens in this unique context. We collected throat swab samples from 308 patients with a fever from outpatient and emergency departments at sentinel surveillance hospitals in Xiamen, southeast of China, between April and May 2023, testing for SARS-CoV-2 and 26 other respiratory pathogens. The coinfection rate of the XBB SARS-CoV-2 variant with other respiratory pathogens was higher than that observed during the Alpha and Delta phases. Among patients with influenza, bacterial coinfections were more prevalent. Only 0.65% (2/308) of the patients were concurrently infected with both COVID-19 and influenza. Age-stratified analysis showed a clear pattern, with a higher incidence of coinfections in children under 18 years of age. These findings highlight the need for the timely detection of respiratory pathogen coinfections and for the implementation of appropriate interventions, crucial for reducing disease burden during intersecting respiratory epidemics.