ArticleJMIR public health and surveillance2023
Seesaw Effect Between COVID-19 and Influenza From 2020 to 2023 in World Health Organization Regions: Correlation Analysis.
Article in JMIR public health and surveillance, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Efficacy and Safety of Respiratory Syncytial Virus (RSV) Prefusion F Protein Vaccine (RSVPreF3 OA) in Older Adults Over 2 RSV Seasons.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Trial
- Trends in Emergency Department utilization by disease categories in a migrant-dense high-income setting: a retrospective study in Dubai, 2021-2025.International journal of emergency medicine · 2026Article
- Epidemiological profile of respiratory viruses associated with influenza-like illness and severe acute respiratory infection in Guangzhou, China, 2024-2025.Frontiers in public health · 2026Article
- Epidemiological characteristics of imported influenza viruses at Shanghai entry-exit ports from 2017 to 2024.Frontiers in public health · 2026Article
- Dynamic ensemble deep learning with multi-source data for robust influenza forecasting in Yangzhou.BMC public health · 2025Article
- A 14-year influenza reinfection surveillance in Chongqing, China: A retrospective analysis.Human vaccines & immunotherapeutics · 2025Article
- Changing Epidemiological Pattern and Higher Disease Burden of Influenza in China, 2022 to 2025.Influenza and other respiratory viruses · 2025Article
- Healthcare-Seeking behavior for acute respiratory infections in a community population in Southwest China during the 2021-2023 influenza seasons.BMC infectious diseases · 2025Article
- Quantitative assessment of Public Health and Social Measures implementation and relaxation on influenza transmission during COVID-19 in China: SEIABR and GBDT models.Journal of global health · 2024Article
- Influenza A virus continues to circulate among children in Linyi, northern China, after the relaxation of COVID-19 control measures.Scientific reports · 2024Article
- Changes in the Epidemiological Features of Influenza After the COVID-19 Pandemic in China, the United States, and Australia: Updated Surveillance Data for Influenza Activity.Interactive journal of medical research · 2024Article
- Comparative Epidemiological and Clinical Outcomes on COVID-19 and Seasonal Influenza Hospitalized Patients during 2023.Infectious disease reports · 2024Article
- Vertebral bone quality score was associated with paraspinal muscles fat infiltration, but not modic classification in patients with chronic low back pain: a prospective cross-sectional study.BMC musculoskeletal disorders · 2024Article
- Viral interference between severe acute respiratory syndrome coronavirus 2 and influenza A viruses.PLoS pathogens · 2024Article
- Clinical Presentation and Co-Detection of Respiratory Pathogens in Children Under 5 Years with Non-COVID-19 Bacterial and Viral Respiratory Tract Infections: A Prospective Study in Białystok, Poland (2021-2022).Medical science monitor : international medical journal of experimental and clinical research · 2023Article
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10 authors.
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Abstract
backgroundSeasonal influenza activity showed a sharp decline in activity at the beginning of the emergence of COVID-19. Whether there is an epidemiological correlation between the dynamic of these 2 respiratory infectious diseases and their future trends needs to be explored.
objectiveWe aimed to assess the correlation between COVID-19 and influenza activity and estimate later epidemiological trends.
methodsWe retrospectively described the dynamics of COVID-19 and influenza in 6 World Health Organization (WHO) regions from January 2020 to March 2023 and used the long short-term memory machine learning model to learn potential patterns in previously observed activity and predict trends for the following 16 weeks. Finally, we used Spearman correlation coefficients to assess the past and future epidemiological correlation between these 2 respiratory infectious diseases.
resultsWith the emergence of the original strain of SARS-CoV-2 and other variants, influenza activity stayed below 10% for more than 1 year in the 6 WHO regions. Subsequently, it gradually rose as Delta activity dropped, but still peaked below Delta. During the Omicron pandemic and the following period, the activity of each disease increased as the other decreased, alternating in dominance more than once, with each alternation lasting for 3 to 4 months. Correlation analysis showed that COVID-19 and influenza activity presented a predominantly negative correlation, with coefficients above -0.3 in WHO regions, especially during the Omicron pandemic and the following estimated period. The diseases had a transient positive correlation in the European region of the WHO and the Western Pacific region of the WHO when multiple dominant strains created a mixed pandemic.
conclusionsInfluenza activity and past seasonal epidemiological patterns were shaken by the COVID-19 pandemic. The activity of these diseases was moderately or greater than moderately inversely correlated, and they suppressed and competed with each other, showing a seesaw effect. In the postpandemic era, this seesaw trend may be more prominent, suggesting the possibility of using one disease as an early warning signal for the other when making future estimates and conducting optimized annual vaccine campaigns.
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