In Kerala, a co-infection of COVID-19 with other respiratory pathogens-H1N1 flu-a, has surfaced. Even though a meagre percentage of COVID-19 patients have influenza, however, this situation cannot be ignored, especially in the elderly and individuals at high risk. 

Three cases of co-infection of H1N1 in COVID-19 have been reported in Thiruvananthapuram, a new trend so far seen only in Kerala. The state has witnessed a rise in swine flu (H1N1) cases. Of the three patients with the co-infections, two had mild symptoms, but one patient was critical. 

A reason for undetected cases of H1N1 is that most of the labs are not testing for H1N1 because of the high cost of the tests. H1N1 tests are only performed when a patient develops pneumonia and other associated complications. 

Global data shows that influenza was prevalent in 0.8% of patients with COVID-19, with a frequency of co-infection of 4.5% in Asia and 0.4% in America. Both men and women are equally vulnerable. While most of the patients survived, about 7% died. 

The key to prevention is the annual influenza vaccine with Covid vaccine, particularly in at-risk or susceptible individuals. 

[Resource: https://health.economictimes.indiatimes.com/news/diagnostics/h1n1-covid-combo-seen-in-kerala-patients/94445807]