Prevalence and trends in mono- and co-infection of Covid-19, influenza A/B, and respiratory syncytial virus, January 2018–June 2023

Objectives: 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. Methods: sites from January 2018 to June 2023, comparing positivity rates and co-infection rates by age, sex, and seasonality. Results: In 2021-2023, 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. Conclusion: 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

Disease · Environmental health · Influenza A virus · Pandemic · Population · Respiratory system · Virus · COVID-19 Clinical Research Studies · Medicine · Respiratory viral infections research · SARS-CoV-2 detection and testing · Internal Medicine · Virology

• Severe outcomes of individual or multiple respiratory viral infections in a large national healthcare system, 2022–2023

  Open Access•Janet M Grubber, Ikwo K Oboho et al.•Frontiers in Public Health•2026

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