2021 NIH COVID-19 Influenza Co-infection Guidelines – Guideline Knowledge Check

Andrea Eberly, MD, MS, FAAEMEmergency Medicine, Family Medicine, Guideline Knowledge Check, Internal Medicine, Medical News, Nurse Practitioner, Pediatric Emergency Medicine, Pediatric Medicine, Physician Assistant, Urgent Care

COVID-19 Influenza Coinfection Treatment Guidelines 2021 Patient Case - Guideline Knowledge Check

Updated National 2021 COVID-19 Guidelines Address the Risk and Treatment of Co-infection with Influenza in Patients Hospitalized for COVID-19

This Guideline Knowledge Check reviews three sets of newly updated COVID-19 Guidelines (Coronavirus Treatment Guidelines) from the NIH address the risk and treatment of co-infection with influenza in patients hospitalized for COVID-19. According to the National Institutes of Health (NIH), how does infection with COVID-19 affect empiric treatment of influenza?

Today’s Guideline Knowledge Check question comes from the desk of Med-Challenger Emergency Medicine Editor-in-Chief, Andrea Eberly, MD, FAAEM.

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Try this COVID-19 guideline question and find out if you’re in step with the the most current Coronavirus treatment guidelines regarding influenza co-infection.

A 28-year-old female arrives during the winter with signs of a severe respiratory illness and acute respiratory distress syndrome (ARDS).

She is intubated and low tidal volume ventilation (LTVV) is initiated.

She has recently tested positive for SARS-CoV-2.

Both SARS-CoV-2 and influenza are circulating in the community, so she is now also tested for influenza, with the test results currently pending.


What does the COVID-19 panel of the National Institutes of Health (NIH) recommend with regards to empiric treatment for influenza in patients with COVID-19 when both SARS-CoV-2 and influenza are co-circulating in the patient’s community?

Answer Options:

Empiric treatment of influenza is not recommended in hospitalized patients with SARS-CoV-2 infection even if the two pathogens are co-circulating in the community.

In hospitalized patients with COVID-19, treatment (empiric or not) with the anti-influenza drugs zanamivir or oseltamivir is contraindicated in because both inhibit remdesivir.

In hospitalized patients with COVID-19, treatment (empiric or not) with zanamivir or oseltamivir is recommended over oseltamivir because only oseltamivir inhibits remdesivir.

Empiric treatment with oseltamivir for influenza should be started prior to influenza test results in all hospitalized patients with COVID-19 who come from a community with co-circulation of SARS-CoV-2 and influenza.

See the Answer:

2021 COVID-19 Guidelines for COVID-19 co-infection of influenza

About Guideline Knowledge Checks:

With each update of national clinical practice guidelines, some recommendations change and many remain unchanged. Med-Challenger Guideline Knowledge Checks help you know both what is new and what has stayed the same in the most recent guidelines pertinent to each medical specialty.

About the Author:

Andrea Eberly, MD, FAAEM graduated from the David Geffen Medical School of Los Angeles (UCLA) and completed her residency in Emergency Medicine at the University Medical Center, Tucson, Arizona. After working as an attending physician in Tucson, she followed a recruiting call to the island of Guam, where she served in various roles, including as the director of the emergency department, the EMS Medical Director of Guam, and the Director of the 911 Call System. She has maintained her emergency medicine board certification through three cycles of American Board of Emergency Medicine Board Exams (last in 2014), all three with the help of Med-Challenger.

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