What Happens if You Have More Than One Virus at a Time?

It’s the big question right now.

With COVID-19 continuing to be a health challenge alongside flu and other respiratory illnesses in western Massachusetts and across the nation, can you have more than one virus at the same time?

The answer is – yes.

What is a Co-Infection?

“Co-infections have become a growing concern in recent months in response to the COVID-19 pandemic,” said Dr. Armando Paez, chief, Infectious Disease Division, Baystate Health. “And it is a concern for both adults and children who can develop simultaneous infections.”

Co-infection occurs when two or more infectious agents infect the same person at the same time, and it is highly concerning with regards to respiratory diseases such as:

• COVID-19
• Influenza (flu)
• Respiratory Syncytial Virus (RSV).

Patients who contract these co-infections may experience more severe symptoms and an increased mortality rate than those infected by only one virus.

“Hospitalization is often required for those suffering from co-infections due to their more serious cases of illness,” Dr. Paez said, noting the rate of co-infections has increased significantly during this unprecedented health crisis.

Will Having Two Viruses Make You Sicker?

A study published in the journal Pediatrics on January 18, 2023, showed that children younger than five years old with COVID-19 and a co-infection of another respiratory virus such as flu, RSV or rhinovirus were more likely to experience severe illness than children with only one virus or older children and adolescents.

Out of around 4,000 children in the study with respiratory infections, around 20% had co-infections, or what the study researchers called co-detections. Children under five with co-infections had about twice the odds of having severe illness, meaning they were significantly more likely to need oxygen to help them breathe or to need the ICU.

Previous studies among adults with co-infections of COVID-19 and other respiratory viruses have been associated with an increased risk of needing to be put on oxygen and higher odds of death.

That is why it is so important to employ the tools available to prevent these respiratory infections in the first place, Dr. Paez noted.

How to Prevent Respiratory Co-Infections

“Vaccination against flu and COVID-19, while may not completely protect adults and children from getting the infection, [they] will likely protect from getting very ill, particularly in the unfortunate event that you end up having both or one after the other,” he said.

Other preventive measures that will help reduce the spread of infection include wearing appropriate facemasks in crowded or poorly ventilated public indoor places, particularly if one has a weakened immune system, is under 5, or is elderly, which are risk factors for a more severe course of viral respiratory illness.

What To Do If You’re Sick

“If you feel sick with respiratory illness, get tested, stay at home, practice proper cough etiquette and wash your hands frequently.”

If your child is sick, consult with your pediatrician and familiarize yourself with the severe symptoms that need immediate medical attention.

Co-infections of respiratory illnesses do occur and are not limited only to viruses, but also to bacteria.

“In these situations, you may need to see the doctor to get tested and treated. Treatments will depend on if it is all viral or a combination of bacterial and viral infections. Symptoms to watch for include unrelenting fever, shortness of breath, chest pain and confusion. These are warning signs of severe illness that may need further medical evaluation,” Dr. Paez said.

Contact your primary care provider, but consider your options for convenient care or the emergency department, if your symptoms warrant it or if your primary care office is closed.