COVID-19與流感同步流行的疾病模式及臨床檢測

Clinical Scenarios and Testing in the Upcoming Co-circulation of COVID-19 and Influenza

2019年12月爆發的新興傳染病，新型冠狀病毒（SARS-CoV-2）引起的新冠肺炎（COVID-19），迄今已締造人類歷史最大全球疫情的紀錄，且經歷Alpha、Delta到Omicron一系列高度關注變異株（variants of concern）對各國疫情的衝擊。面對新冠病毒常態流行（endemic）的趨勢，病毒可能繼續變異，而變異株的傳播力及致病力的高度不確定性都是未知，故國際專家強調檢測及持續監測的重要性。近三年因新冠疫情的積極防堵，許多國家流感等呼吸道傳播之病毒疫情同步獲益。近期各國特殊防疫措施逐漸鬆綁，國際專家預測流感等病毒疫情將大爆發，監測資料已經發現個案提前增加之趨勢。此外研究顯示，新冠肺炎病人約10%有合併其他感染，包括細菌或流感等。今年秋冬呼吸道疾病，檢驗此新冠病毒和流感病毒可能成為新常態，一如疫情初期之作為。此外，重症病人可考慮同時檢測多種病菌的快速定點照護（point of care）多重核酸檢驗，及早確定診斷，積極投與確切的抗病毒藥物治療，以避免重症甚至死亡。並同步進行適當隔離防護，以避免醫療機構內群聚感染。

The COVID-19 pandemic is the largest in human history in terms of the number of confirmed cases and death tolls. Uncertainty of SARS CoV-2 regarding transmissibility and severity in the future remains, considering the rapidly emerging and global spread of a series of variants of concern, including alpha, delta, and omicron, in the past 2-3 years. COVID-19 is likely to become endemic. In addition, surveillance data have shown that influenza and other respiratory viruses resurge following lifting control measures. Up to 10% of COVID-19 patients are co-infected with bacteria, influenza, and other pathogens. Thus, continuous surveillance at the population level and simultaneous testing for both SARS-CoV-2 and influenza viruses when indicated will become the new norm. This practice facilitates early specific antiviral treatment to improve outcomes, particularly in critically ill or immunocompromised patients. In addition, appropriate isolation precautions should be implemented to prevent intra-hospital spread.