Dear all, I wish to share with you about 2 patients who tested positive for both covid and swine flu at same time. Its a dual covid plus swine flu infection together. One of them is a 71 yr old diabetic male patient , presented with fever, sore throat, severe cough for 3 days. PCR test for both covid 19 and h1n1 were done. He tested positive for both. Ct scan of chest was clear with ct score of 0. CRP was 42. D dimer was 582, IL-6 was normal. Oxygen saturation was 98% on room air. Second patient is his wife, 70 yr old female with history of mastectomy for ca breast, hypothyroidism and obesity. She complained of fever and sore throat for 2 days. PCR tests for covid 19 and h1n1 were done. Both tested positive. CT scan chest was normal with score of 0. CRP was 8, IL6, d-Dimer in range, ferritin 1200. Oxygen saturation 97% on room air. Hospital based isolation was advised to both being dual positive with age and comorbidities. However they opted for home isolation against medical advice. Favipiravir was started for them in usual covid dose. It being a broad spectrum antivirus, it acts on influenza virus as well. Supportive medicines as antipyretics, oral decongestants , vitamin c and zinc given. Their old medications were continued unchanged. Today is day 3 of their treatment. I shall keep you all posted about the progress. Dr Hardik Thakker, MD MED, ECFMG (USA).