Can ‘Flurone’ cause more severe respiratory conditions? Understand

Cases of ‘flurone’, as the co-infection of Covid-19 and influenza became known, have already been recorded in some parts of the country. The diagnoses come at a time when Brazil is facing a strong wave of severe flu cases that already fill hospitals in some cities.

A leaf talked to some experts to understand if there is any peculiarity in cases of a person who is infected by two viruses and what effects the double infection by Covid-19 and influenza can have on a patient.

The first point is that a double infection caused by a virus is common, explains Fernando Spilki, virologist and coordinator of the Corona-Omic BR-MCTI Network, a laboratory project that sequences the genomes of SARS-Cov-2 samples in Brazil.

“When are you going to study outside of a pandemic period? […], you find a very high percentage of coinfection [entre diferentes vírus]”, he says.

Spilki details that, in 2020, the first year of the pandemic, cases of co-infection between Sars-CoV-2 and H1N1 had already been detected. These diagnoses were rarer because there was little circulation of influenza in Brazil. However, the scenario has changed.

“Now the perfect storm is formed: you have a lot of H3N2 infections, especially this Darwin strain that is responsible for this current outbreak in Brazil, and on the other hand you have […] a wave forming with an omicron. So it will give a lot of chance for people to co-infect themselves with these two [patógenos]”, it says.

Even with this scenario, Spilki says that there are no indications that a positive diagnosis of flu and Covid can lead to more serious situations in patients.

“We even see cases of co-infection in people with mild disease, so it’s not the fact of having co-infection [que necessariamente indica a severidade da doença]”, he says.

It is the same vision of Cristina Bonorino, immunologist and professor at UFCSPA (Federal University of Health Science of Porto Alegre).

“It seems to be an intuitive thing to say that if you have more than one virus at the same time, it will get worse, but in fact this is not what happens, it depends a lot on the person, age, comorbidities”, he says.

In the case of co-infections with Sars-CoV-2, Bonorino explains that “no [estudo] shows an increased risk”, but she also stresses the need to continue monitoring the situation as the coronavirus is still very new.

She also says that co-infection cases are now being reported more because sanitary measures are being relaxed, which had not happened on a large scale before.

“We had a drop in influenza cases last year because of distancing and because of masks, which inhibit the circulation of all viruses. having the flu”, he says.

A similar aspect is pointed out by Maurício Nogueira, professor at the medical school of São José do Rio Preto. He says that the greater circulation of various viruses across the country is “a reflection of the total liberalization that we did after two years stopped”.

The critical panorama is already felt in different regions. Hospitals, for example, already have to deal with the increase in patients with Srag (Severe Acute Respiratory Syndrome). Gerson Salvador, doctor at the University Hospital of USP (University of São Paulo) and author of the blog “Linha de Frente” in leaf, has already observed the increase in critical cases in patient care.

He reports that, in mid-November, the increase in the number of patients with Srag was already visible and that most were positive cases of influenza. Salvador relates this to the flu epidemic in Rio de Janeiro.

In December, however, the numbers of Covid-19 cases also rose. “We saw a very fast increase in the cases of Covid-19. At this moment, we have to deal with patients with influenza and severe Covid”, says Salvador.

The doctor, however, reiterates that this situation is not necessarily related to the co-infection of coronavirus and influenza itself, but to the high rate of spread of the two viruses in Brazil, which can result in respiratory complications even in infections of only one of the pathogens.

“Being infected with two viruses at the same time does not mean that you will have a more serious condition. [Isso] It’s not another disease,” he says.

Nogueira also argues that co-infection between viruses should not be the central point of concern, as it is “a relatively common phenomenon”.

“We have to worry about Covid, the forms of transmission and vaccination”, he says.

The diagnoses of Sars-CoV-2 have risen sharply again in the face of the ômicron variant, which has a high rate of transmissibility.

A survey carried out with more than 2,400 samples of special RT-PCR tests identified an average prevalence of 92% of the new variant in Covid-19 positives in Brazil.

Preliminary data also already indicate that the two-dose or single-dose vaccine schedule has a significant reduction in neutralizing antibodies against the Ômicron. Even so, immunizations are still extremely important to prevent serious cases of the disease, such as hospitalizations and deaths.

For Nogueira, the exacerbated transmission of the onomicron and the defective vaccination of children are the major Brazilian health problems that need to be addressed.

“Omicrons, the high transmission rate and the delay in vaccinating children: these are problems that we have to discuss”, he concludes.