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• Non-pharmaceutical interventions are associated with the decline of COVID-19 cases. • These interventions directly reduced the transmission of respiratory pathogens. • These interventions are cost-effective. • These interventions should be implemented before more effective approaches become available. The emergence of a novel coronavirus, SARS-CoV-2, and its subsequent spread outside of Wuhan, China, led to the human society experiencing a pandemic of coronavirus disease 2019 (COVID-19). While the development of vaccines and pharmaceutical treatments are ongoing, government authorities in China have implemented unprecedented non-pharmaceutical interventions as primary barriers to curb the spread of the deadly SARS-CoV-2 virus. Although the decline of COVID-19 cases coincided with the implementation of such interventions, we searched for evidence to demonstrate the efficacy of these interventions, since artifactual factors, such as the environment, the pathogen itself, and the phases of epidemic, may also alter the patterns of case development. We surveyed common viral respiratory infections that have a similar pattern of transmission, tropism, and clinical manifestation, as COVID-19 under a series of non-pharmaceutical interventions during the current pandemic season. We then compared this data with historical data from previous seasons without such interventions. Our survey showed that the rates of common respiratory infections, such as influenza and respiratory syncytial virus infections, decreased dramatically from 13.7% (95% CI, 10.82–16.58) and 4.64% (95% CI, 2.88–7.64) in previous years to 0.73% (95% CI, 0.02–1.44) and 0.0%, respectively, in the current season. Our surveillance provides compelling evidence that non-pharmaceutical interventions are cost-effective ways to curb the spread of contagious agents, and may represent the only practical approach to limit the evolving epidemic until specific vaccines and pharmaceutical treatments are available. [ABSTRACT FROM AUTHOR]

• The clinical manifestations of COVID-19 children are milder than those of influenza A children under 5 years. • The laboratory tests of COVID-19 children are milder than those of influenza A children under 5 years. • Imaging results more commonly presented as ground-glass opacities in COVID-19 patients. Since the outbreak of Coronavirus Disease 2019 (COVID-19) in Wuhan, considerable attention has been paid to its epidemiology and clinical characteristics in children. However, it is also crucial for clinicians to differentiate COVID-19 from other respiratory infectious diseases, such as influenza viruses. This was a retrospective study. Two groups of COVID-19 patients (n = 57) and influenza A patients (n = 59) were enrolled. We analyzed and compared their clinical manifestations, imaging characteristics and treatments. The proportions of cough (70.2%), fever (54.4%) and gastrointestinal symptoms (14.1%) in COVID-19 patients were lower than those of influenza A patients (98.3%, P < 0.001; 84.7%, P < 0.001; and 35.6%, P = 0.007; respectively). In addition, COVID-19 patients showed significantly lower levels of leukocytes (7.87 vs. 9.89 × 109 L–1, P = 0.027), neutrophils (2.43 vs. 5.16 × 109 L–1, P < 0.001), C-reactive protein (CRP; 3.7 vs. 15.1 mg/L, P = 0.001) and procalcitonin (PCT; 0.09 vs. 0.68 mm/h, P < 0.001), while lymphocyte levels (4.58 vs. 3.56 × 109 L–1; P = 0.006) were significantly higher compared with influenza A patients. In terms of CT imaging, ground-glass opacification in chest CT was more common in COVID-19 patients than in influenza A patients (42.1% vs. 15%, P = 0.032). In contrast, consolidation was more common in influenza A patients (25%) than in COVID-19 patients (5.2%, P = 0.025). The clinical manifestations and laboratory tests of COVID-19 children are milder than those of influenza A children under 5 years. Additionally, imaging results more commonly presented as ground-glass opacities in COVID-19 patients. [ABSTRACT FROM AUTHOR]

• A high proportion of COVID-19 patients were co-infected with influenza in Tongji Hospital (Wuhan). • Critically ill COVID-19 patients with influenza were more prone to cardiac injury than those without influenza. • Co-infection with the influenza virus may induce an earlier and more frequently occurring cytokine storm in critically ill COVID-19 patients. • Do not ignore detection of the influenza virus in patients with COVID-19. To delineate the clinical characteristics of critically ill COVID-19 patients co-infected with influenza. This study included adult patients with laboratory-confirmed COVID-19 form Tongji Hospital (Wuhan, China), with or without influenza, and compared their clinical characteristics. Among 93 patients, 44 died and 49 were discharged. Forty-four (47.3%) were infected with influenza virus A and two (2.2%) with influenza virus B. Twenty-two (50.0%) of the non-survivors and 24 (49.0%) of the survivors were infected with the influenza virus. Critically ill COVID-19 patients with influenza were more prone to cardiac injury than those without influenza. For the laboratory indicators at admission the following were higher in non-survivors with influenza than in those without influenza: white blood cell counts, neutrophil counts, levels of tumor necrosis factor-α, D-dimer value, and proportion of elevated creatinine. The results showed that a high proportion of COVID-19 patients were co-infected with influenza in Tongji Hospital, with no significant difference in the proportion of co-infection between survivors and non-survivors. The critically ill COVID-19 patients with influenza exhibited more severe inflammation and organ injury, indicating that co-infection with the influenza virus may induce an earlier and more frequently occurring cytokine storm. [ABSTRACT FROM AUTHOR]