As flu season approaches some people are asking if it is possible to contract COVID-19 and the flu at the same time.

Unfortunately, yes, you can have both viruses, says Dr. Carl S. Goldstein, Clinical Professor of Medicine at Rutgers-Robert Wood Johnson Medical School.

These are different viruses and because they are structurally different, there is no cross-immunity, Goldstein says.

And if you have both? The risk of respiratory failure requiring a ventilator or cardiopulmonary death is much greater, he says.

The concern is that both of these diseases converge on respiratory failure, Goldstein explains. So COVID independently can lead to ventilator-dependent respiratory failure, as can influenza, and influenza notoriously can set the stage for a bacterial pneumonia occurring on top of influenza. So the risk is that if you are infected with both COVID and influenza, they will both exact harm independently and, likely, synergistically.

Goldstein says those who are already at risk for poor outcomes from COVID are exactly the same people who are at risk for poor outcomes when it comes to the flu.

"That population over 65, underlying cardiac or pulmonary disease, chronic kidney disease, diabetes, HIV, AIDS, cancer or cancer chemotherapy, organ transplant recipient that whole list of people who are at-risk people,' now become at really high risk people, he says, but adds that the the strategies which protect against COVID (masks, hand hygiene and physical distance) are "exactly the same strategies that protect against influenza, making these protective behaviors even more important.

How to tell whether you have COVID-19, the flu or both is a call best made by your physician, Goldstein says, adding that early intervention is critical for high-risk patients.

Clinically they both may present with fever, cough, muscle aches and pains. You cannot rely on symptoms to discriminate between these two diseases or between more common viral infections, he says. And if youre a person at risk and you develop respiratory symptoms any of them: fever, chills, cough, congestion shortness of breath, any of them if those symptoms are anything other than really ordinary, that probably deserves medical assessment because both influenza and COVID can get really ugly, fairly quickly.

And if its just the flu, an early diagnosis can often lead to effective therapy with Tamiflu or other antiviral agents, which, in some cases, could be lifesaving, Goldstein says.

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Jessica Remo may be reached at jremo@njadvancemedia.com.

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Can you have both COVID-19 and the flu at the same time? - NJ.com