Volume 31, No 4, Apr 2021

ISSN: 1001-0602 
EISSN: 1748-7838 2018 
impact factor 17.848* 
(Clarivate Analytics, 2019)

Volume 31 Issue 4, April 2021: 395-403   |  Open Access

ORIGINAL ARTICLES

Coinfection with influenza A virus enhances SARS-CoV-2 infectivity

Lei Bai¹ , Yongliang Zhao¹ , Jiazhen Dong , Simeng Liang¹ , Ming Guo¹ , Xinjin Liu¹ , Xin Wang¹ , Zhixiang Huang¹ , Xiaoyi Sun¹ , Zhen Zhang¹ , Lianghui Dong¹ , Qianyun Liu¹ , Yucheng Zheng¹ , Danping Niu¹ , Min Xiang¹ , Kun Song¹ , Jiajie Ye¹ , Wenchao Zheng¹ , Zhidong Tang¹ , Mingliang Tang¹ , Yu Zhou¹ , Chao Shen¹ , Ming Dai² , Li Zhou^1,2 , Yu Chen¹ , Huan Yan¹ , Ke Lan^1,2,3,* , Ke Xu^1,*

¹State Key Laboratory of Virology, College of Life Sciences, Wuhan University, Wuhan, Hubei 430072, China
²Animal Biosafety Level 3 Laboratory, Wuhan University, Wuhan, Hubei 430072, China
³Frontier Science Center for Immunology and Metabolism, Wuhan University, Wuhan, Hubei 430072, China
These authors contributed equally: Lei Bai, Yongliang Zhao, Jiazhen Dong, Simeng Liang, Ming Guo. Correspondence: Ke Lan(klan@whu.edu.cn)Ke Xu(xuke03@whu.edu.cn)

The upcoming flu season in the Northern Hemisphere merging with the current COVID-19 pandemic raises a potentially severe threat to public health. Through experimental coinfection with influenza A virus (IAV) and either pseudotyped or live SARS-CoV-2 virus, we found that IAV preinfection significantly promoted the infectivity of SARS-CoV-2 in a broad range of cell types. Remarkably, in vivo, increased SARS-CoV-2 viral load and more severe lung damage were observed in mice coinfected with IAV. Moreover, such enhancement of SARS-CoV-2 infectivity was not observed with several other respiratory viruses, likely due to a unique feature of IAV to elevate ACE2 expression. This study illustrates that IAV has a unique ability to aggravate SARS-CoV-2 infection, and thus, prevention of IAV infection is of great significance during the COVID-19 pandemic.

https://doi.org/10.1038/s41422-021-00473-1

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