The emergence of influenza B as a major respiratory pathogen in the absence of COVID-19 during the 2021–2022 flu season in China

Virology Journal

Research

Lili Wang¹  Mingui Lin¹  Lixin Xie²  De Chang³  Zhiqing Xiao³  Kailong Li⁴  Yu Zhang⁵  Ning Song⁵  DeZhi Liu⁶  Wenkui Sun⁷  Jing Gao⁸  Lihua Xing⁸  Hongmei Liu⁹  Xuan Zhou^1,10  Lokesh Sharma^1,11  Shujun Li^1,12  Zhantao Zhu^1,13  Bin Yang^1,14  Yongjun Li^1,14 

[1] Beijing Tsinghua Changgung Hospital, Tsinghua University School of Medicine, 102218, Beijing, China;College of Respiratory and Critical Care Medicine, Chinese PLA General Hospital, 100083, Beijing, China;College of Respiratory and Critical Care Medicine, Chinese PLA General Hospital, 100083, Beijing, China;Department of Pulmonary and Critical Care Medicine, 7th Medical Center of Chinese, PLA General Hospital, 100007, Beijing, China;Department of Biochemistry and Biophysics, Peking University Health Science Center, 100191, Beijing, China;Department of Infectious Diseases, The Second Hospital of Hebei Medical University, 050000, Shijiazhuang, Hebei, China;Department of Pediatrics, Xinxiang Central Hospital, 453000, Xin Xiang, Henan, China;Department of Respiratory & Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, 210029, Nanjing, Jiangsu, China;Department of Respiratory Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, Henan, China;Department of Respiratory and Critical Care Medicine, Henan Provincial People’s Hospital, 450003, Zhengzhou, Henan, China;Department of the Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, 230011, Hefei, Anhui, China;Section of Pulmonary and Critical Care and Sleep Medicine, Yale University School of Medicine, 06520-8057, New Haven, CT, USA;The First Affiliated Hospital of Xinxiang Medical University, 453199, Weihui, Henan, China;Third Medical Center, Chinese PLA General Hospital, 100039, Beijing, China;Vision Medicals Center for Infectious Diseases, 510000, Guangzhou, Guangdong, China;

关键词: Influenza B;    COVID-19;    Respiratory tract infection;    Pneumonia;   

DOI  :  10.1186/s12985-023-02115-x

 received in 2023-03-05, accepted in 2023-07-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe emergence of COVID-19 and the implementation of preventive measures and behavioral changes have led to a significant decrease in the prevalence of other respiratory viruses. However, the manner in which seasonal viruses will reemerge in the absence of COVID-19-related restrictions remains unknown.MethodsPatients presenting with influenza-like illness in two hospitals in Beijing were subjected to testing for COVID-19, influenza A, and influenza B to determine the causative agent for viral infections. The prevalence of influenza B across China was confirmed using data from the Centers for Disease Control, China (China CDC). Clinical characteristics, laboratory findings, imaging results, and mortality data were collected for a cohort of 70 hospitalized patients with confirmed influenza B from 9 hospitals across China.ResultsStarting from October 2021, a substantial increase in the number of patients visiting the designated fever clinics in Beijing was observed, with this trend continuing until January 2022. COVID-19 tests conducted on these patients yielded negative results, while the positivity rate for influenza rose from approximately 8% in October 2021 to over 40% by late January 2022. The cases started to decline after this peak. Data from China CDC confirmed that influenza B is a major pathogen during the season. Sequencing of the viral strain revealed the presence of the Victoria-like lineage of the influenza B strain, with minor variations from the Florida/39/2018 strain. Analysis of the hospitalized patients' characteristics indicated that severe cases were relatively more prevalent among younger individuals, with an average age of 40.9 ± 24.1 years. Among the seven patients who succumbed to influenza, the average age was 30 ± 30.1 years. These patients exhibited secondary infections involving either bacterial or fungal pathogens and displayed elevated levels of cell death markers (such as LDH) and coagulation pathway markers (D-dimer).ConclusionInfluenza B represents a significant infection threat and can lead to substantial morbidity and mortality, particularly among young patients. To mitigate morbidity and mortality rates, it is imperative to implement appropriate vaccination and other preventive strategies.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 2

Fig. 6