In the winters of 20 & 21, respiratory wards were filled with Covid-19 patients with high mortality rates. Our respiratory unit saw a 54% mortality rate in the first wave.

In winter 2022, a warning of triple threat: Flu, respiratory syncytial virus (RSV) and Covid 19, the ?tripledemic?, was given.

We wanted to analyse our patients with viral illness. We reviewed their oxygen requirement, respiratory support - high flow oxygen therapy (HFNO), non-invasive ventilation (NIV), continuous positive airway pressure (CPAP) and mechanical ventilation (MV), history of underlying respiratory diseases and 30-day mortality.

Between 01/12/22 to 31/12/22, out of 78 patients, 29.5 % had viral illness confirmed by polymerase chain reaction. 52% male. Average age was 71. Mean clinical frailty score was 5. 69.5% had 1 or more underlying lung conditions (Fig1). 91% required supplementary oxygen (up to 15L). 22% needed NIV. Surprisingly, none received HFNO, CPAP or MV. 13% died within 30 days.

48% had Covid-19, 39% had Flu A and 22% had RSV. 2 had both Covid and Flu. Both survived. Of those needing NIV, 60% had Flu and 40% had RSV (1 died). 80% NIV patients had 1-2 respiratory conditions.

Our study showed having 2 concurrent viruses didn?t worsen outcome. Mortality rate was lower compared to pandemic. However, more studies are needed to look at the health impact from winter respiratory viruses.