Sequential Infection with Influenza A Virus Followed by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Leads to More Severe Disease and Encephalitis in a Mouse Model of COVID-19

Clark, Jordan J., Penrice-Randal, Rebekah, Sharma, Parul, Dong, Xiaofeng, Pennington, Shaun ORCID: https://orcid.org/0000-0002-7160-6275, Marriott, Amy, Colombo, Stefano, Davidson, Andrew, Kavanagh Williamson, Maia, Matthews, David A., Turtle, Lance, Prince, Tessa, Hughes, Grant ORCID: https://orcid.org/0000-0002-7567-7185, Patterson, Ian ORCID: https://orcid.org/0000-0003-3465-0848, Shawli, Ghada, Mega, Daniele F., Subramaniam, Krishanthi, Sharp, Jo, Turner, Joseph ORCID: https://orcid.org/0000-0002-2185-5476, Biagini, Giancarlo ORCID: https://orcid.org/0000-0001-6356-6595, Owen, Andrew, Kipar, Anja, Hiscox, Julian A. and Stewart, James P. (2024) 'Sequential Infection with Influenza A Virus Followed by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Leads to More Severe Disease and Encephalitis in a Mouse Model of COVID-19'. Viruses, Vol 16, Issue 6, e863.

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Abstract

COVID-19 is a spectrum of clinical symptoms in humans caused by infection with SARS-CoV-2. The coalescence of SARS-CoV-2 with seasonal respiratory viruses, particularly influenza viruses, is a global health concern. To understand this, transgenic mice expressing the human ACE2 receptor (K18-hACE2) were infected with influenza A virus (IAV) followed by SARS-CoV-2 and the host response and effect on virus biology was compared to K18-hACE2 mice infected with IAV or SARS-CoV-2 alone. The sequentially infected mice showed reduced SARS-CoV-2 RNA synthesis, yet exhibited more rapid weight loss, more severe lung damage and a prolongation of the innate response compared to the singly infected or control mice. Sequential infection also exacerbated the extrapulmonary encephalitic manifestations associated with SARS-CoV-2 infection. Conversely, prior infection with a commercially available, multivalent live-attenuated influenza vaccine (Fluenz Tetra) elicited the same reduction in SARS-CoV-2 RNA synthesis, albeit without the associated increase in disease severity. This suggests that the innate immune response stimulated by IAV inhibits SARS-CoV-2. Interestingly, infection with an attenuated, apathogenic influenza vaccine does not result in an aberrant immune response and enhanced disease severity. Taken together, the data suggest coinfection (‘twinfection’) is deleterious and mitigation steps should be instituted as part of the comprehensive public health and management strategy of COVID-19.

Item Type:	Article
Subjects:	WC Communicable Diseases > WC 20 Research (General) WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 506 COVID-19 WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 515 Human influenza
Faculty: Department:	Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI):	https://doi.org/10.3390/v16060863
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	13 Jun 2024 14:53
Last Modified:	13 Jun 2024 14:53
URI:	https://archive.lstmed.ac.uk/id/eprint/24709

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