Top 5 Takeaways

  1. 6% of pediatric influenza hospitalizations had concurrent SARS-CoV-2 (COVID) coinfection during the 2021–22 influenza season.
  2. Coinfected patients exhibited a higher need for respiratory support (invasive or noninvasive) compared to those with influenza only.
  3. Among pediatric deaths linked to influenza, 16% had SARS-CoV-2 coinfection; vaccination and antiviral use were notably low in these cases.
  4. Data from the CDC’s surveillance networks highlighted the importance of dual-testing for influenza and SARS-CoV-2 in pediatric patients with respiratory symptoms.
  5. The report underscores the need for preventive strategies like vaccinations and mask use during high respiratory virus circulation periods.

Original Article Author and Citation

Corresponding Author

Katherine Adams,, 404-639-0630.

Suggested Citation

Adams K, Tastad KJ, Huang S, et al. Prevalence of SARS-CoV-2 and Influenza Coinfection and Clinical Characteristics Among Children and Adolescents Aged <18 Years Who Were Hospitalized or Died with Influenza — United States, 2021–22 Influenza Season. MMWR Morb Mortal Wkly Rep 2022;71:1589–1596. DOI:


This MMWR article examines the prevalence and severity of coinfections with influenza and SARS-CoV-2 among hospitalized or deceased pediatric patients during the 2021-22 influenza season in the U.S. It reveals that 6% of hospitalized pediatric patients with influenza also had SARS-CoV-2 coinfection. Among pediatric deaths associated with influenza, 16% were coinfected with SARS-CoV-2. The study highlights the increased necessity for respiratory support in coinfected patients compared to those with only influenza.


The study analyzed data from the Respiratory Virus Hospitalizations Surveillance Network (RESP-NET) and the Influenza-Associated Pediatric Mortality Surveillance System. These systems provided insights into hospitalizations and deaths among children and adolescents with laboratory-confirmed influenza virus and SARS-CoV-2 coinfections. The study period was October 2021 to October 2022.


The findings indicate a significant impact of SARS-CoV-2 and influenza coinfection on pediatric morbidity and mortality. Coinfected patients required more invasive respiratory support, and a significant portion of pediatric deaths in the influenza season involved coinfection. The report also points out the low rates of influenza vaccination and antiviral treatment among these pediatric patients.


The study concludes that during the 2021-22 influenza season, coinfection with SARS-CoV-2 and influenza in pediatric patients led to increased severity of illness. It emphasizes the importance of prevention strategies, including influenza and COVID-19 vaccinations, and consideration of mask use during periods of high respiratory virus circulation. Clinicians are encouraged to adopt dual-testing for influenza and SARS-CoV-2 to better manage and treat pediatric patients with respiratory illnesses.

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