Ho John C W, Ng Kachun, Ching Rachel H H, Peiris Malik, Nicholls John M, Chan Michael C W, Hui Kenrie P Y
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
Centre for Immunology and Infection (C2i), Hong Kong Science Park, Shatin, Hong Kong SAR, China.
Microorganisms. 2025 Apr 25;13(5):988. doi: 10.3390/microorganisms13050988.
With the concurrent circulations of SARS-CoV-2 omicron and influenza A viruses in the community, there is evidence showing co-infection with both viruses. However, disease severity may vary due to the complex immunity landscape of the patients and the neutralizing antibody waning status. The intrinsic dynamic relationship and pathological significance for such co-infections remain largely unknown. The replication kinetics and innate immune responses from the co-infections of SARS-CoV-2 (Omicron BA.1 and D614G variant) and influenza A viruses (pandemic H1N1, seasonal H3N2 and highly pathogenic avian H5N1) were characterized in human respiratory tissue explants, human airway, and alveolar epithelial cells. SARS-CoV-2 reduced the replication of influenza A viruses, but not vice versa, during co-infections in human bronchial tissues and airway epithelial cells. In lung tissues, the co-infections showed minimal effects on each other, but the viral replications of the two viruses were mutually reduced except for H1N1pdm in the alveolar epithelial cells irrespective of the enhancement of the ACE2 receptor. Notably, the co-infections showed a significant upregulation of the innate immune responses of SARS-CoV-2 in comparison to single infections in both respiratory epithelial cells, suggesting that co-infections of influenza A viruses potentially lead to more severe damage to the host than SARS-CoV-2 single infections.
随着严重急性呼吸综合征冠状病毒2(SARS-CoV-2)奥密克戎变异株和甲型流感病毒在社区同时传播,有证据表明存在两种病毒的共同感染。然而,由于患者复杂的免疫状况和中和抗体衰减状态,疾病严重程度可能有所不同。这种共同感染的内在动态关系和病理意义在很大程度上仍然未知。在人呼吸道组织外植体、人气道和肺泡上皮细胞中对SARS-CoV-2(奥密克戎BA.1和D614G变异株)与甲型流感病毒(大流行H1N1、季节性H3N2和高致病性禽H5N1)共同感染的复制动力学和先天免疫反应进行了表征。在人支气管组织和气道上皮细胞的共同感染过程中,SARS-CoV-2降低了甲型流感病毒的复制,但反之则不然。在肺组织中,共同感染对彼此的影响最小,但除了肺泡上皮细胞中的甲型H1N1流感病毒外,两种病毒的复制相互减少,而与血管紧张素转换酶2(ACE2)受体的增强无关。值得注意的是,与在呼吸道上皮细胞中的单一感染相比,共同感染显示出SARS-CoV-2先天免疫反应的显著上调,这表明甲型流感病毒的共同感染可能比SARS-CoV-2单一感染对宿主造成更严重的损害。