A case of severe COVID-19 and influenza co-infection

Abstract

Aim. To analyze a case of severe COVID-19 and influenza co-infection in a 48-year-old female patient. Materials and methods. The clinical course, specifics of diagnosis and therapy of the 48-year-old patient S., who was treated for severe co-infection of COVID-19 and influenza at Municipal non-profit Enterprise “Regional Infectious Clinical Hospital” Zaporizhzhіa Regional Council from 29.01.2023 to 17.02.2023, were analyzed. The diagnosis of COVID-19 was confirmed by the detection of SARS-CoV-2 Ag in nasopharyngeal swabs by the immunochromatographic method, and the diagnosis of influenza – by the influenza A viral RNA detection by the polymerase chain reaction method. Current regulatory documents were used when examining and treating the patient. Results. It has been recognized that the unvaccinated 48-year-old female patient was at a risk group due to comorbid pathology (stage 2 hypertension, type 2 diabetes mellitus, grade 2 obesity) developed a severe course of COVID-19 and influenza type A co-infection. The course of co-infection was complicated by severe acute respiratory distress syndrome already on the 6th day of the disease. The diagnosis of COVID-19 was confirmed by a rapid SARS-CoV-2 antigen test. Treatment for COVID-19 was started immediately with the use of remdesivir, dexamethasone, and anticoagulants. However, despite the patient was given the treatment, his condition worsened due to the rapid progression of acute respiratory failure. The presence of clear clinical and laboratory signs of “cytokine storm” required the use of tocilizumab on the 7th day of the disease. Oseltamivir was commenced after receiving laboratory confirmation of influenza A by the PCR method on the 8th day of the disease. A complete etiologic interpretation of the diagnosis made it possible to prescribe a combination antiviral treatment which coupled with the timely additional initiation of tocilizumab, allowed obtaining certain positive dynamics after only five days of treatment with further improvement of the patient’s condition. Conclusions. Our clinical observation has demonstrated the severe course of COVID-19 and influenza co-infection in the unvaccinated high-risk 48-year-old female patient due to the presence of comorbid pathology. The complete etiologic interpretation of the co-infection has made it possible to prescribe the combination antiviral treatment, which coupled with the additional correction of the immunotropic treatment has enabled to obtain the positive dynamics after only 5 days with further improvement of the patient’s condition