Increased lethality in influenza and SARS-CoV-2 coinfection is prevented by influenza immunity but not SARS-CoV-2 immunity

Hagit Achdout, Einat. B. Vitner, Boaz Politi, Sharon Melamed, Yfat Yahalom-Ronen, Hadas Tamir, Noam Erez, Roy Avraham, Shay Weiss, Lilach Cherry, Erez Bar-Haim, Efi Makdasi, David Gur, Moshe Aftalion, Theodor Chitlaru, Yaron Vagima, Nir Paran and Tomer Israely ()
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Hagit Achdout: Israel Institute for Biological Research
Einat. B. Vitner: Israel Institute for Biological Research
Boaz Politi: Israel Institute for Biological Research
Sharon Melamed: Israel Institute for Biological Research
Yfat Yahalom-Ronen: Israel Institute for Biological Research
Hadas Tamir: Israel Institute for Biological Research
Noam Erez: Israel Institute for Biological Research
Roy Avraham: Israel Institute for Biological Research
Shay Weiss: Israel Institute for Biological Research
Lilach Cherry: Israel Institute for Biological Research
Erez Bar-Haim: Israel Institute for Biological Research
Efi Makdasi: Israel Institute for Biological Research
David Gur: Israel Institute for Biological Research
Moshe Aftalion: Israel Institute for Biological Research
Theodor Chitlaru: Israel Institute for Biological Research
Yaron Vagima: Israel Institute for Biological Research
Nir Paran: Israel Institute for Biological Research
Tomer Israely: Israel Institute for Biological Research

Nature Communications, 2021, vol. 12, issue 1, 1-10

Abstract: Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the ongoing coronavirus disease 2019 (COVID-19) pandemic. The continued spread of SARS-CoV-2 increases the probability of influenza/SARS-CoV-2 coinfection, which may result in severe disease. In this study, we examine the disease outcome of influenza A virus (IAV) and SARS-CoV-2 coinfection in K18-hACE2 mice. Our data indicate enhance susceptibility of IAV-infected mice to developing severe disease upon coinfection with SARS-CoV-2 two days later. In contrast to nonfatal influenza and lower mortality rates due to SARS-CoV-2 alone, this coinfection results in severe morbidity and nearly complete mortality. Coinfection is associated with elevated influenza viral loads in respiratory organs. Remarkably, prior immunity to influenza, but not to SARS-CoV-2, prevents severe disease and mortality. This protection is antibody-dependent. These data experimentally support the necessity of seasonal influenza vaccination for reducing the risk of severe influenza/COVID-19 comorbidity during the COVID-19 pandemic.

Date: 2021
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DOI: 10.1038/s41467-021-26113-1

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