Jiangsu Key Laboratory of Medical Science and Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, China.
The Affiliated Hospital, Jiangsu University, Zhenjiang, Jiangsu, China.
J Med Virol. 2021 Mar;93(3):1512-1519. doi: 10.1002/jmv.26469. Epub 2020 Sep 30.
As coronavirus disease 2019 (COVID-19) crashed into the influenza season, clinical characteristics of both infectious diseases were compared to make a difference. We reported 211 COVID-19 patients and 115 influenza patients as two separate cohorts at different locations. Demographic data, medical history, laboratory findings, and radiological characters were summarized and compared between two cohorts, as well as between patients at the intensive care unit (ICU) andnon-ICU within the COVID-19 cohort. For all 326 patients, the median age was 57.0 (interquartile range: 45.0-69.0) and 48.2% was male, while 43.9% had comorbidities that included hypertension, diabetes, bronchitis, and heart diseases. Patients had cough (75.5%), fever (69.3%), expectoration (41.1%), dyspnea (19.3%), chest pain (18.7%), and fatigue (16.0%), etc. Both viral infections caused substantial blood abnormality, whereas the COVID-19 cohort showed a lower frequency of leukocytosis, neutrophilia, or lymphocytopenia, but a higher chance of creatine kinase elevation. A total of 7.7% of all patients possessed no abnormal sign in chest computed tomography (CT) scans. For both infections, pulmonary lesions in radiological findings did not show any difference in their location or distribution. Nevertheless, compared to the influenza cohort, the COVID-19 cohort presented more diversity in CT features, where certain specific CT patterns showed significantly more frequency, including consolidation, crazy paving pattern, rounded opacities, air bronchogram, tree-in-bud sign, interlobular septal thickening, and bronchiolar wall thickening. Differentiable clinical manifestations and CT patterns may help diagnose COVID-19 from influenza and gain a better understanding of both contagious respiratory illnesses.
随着 2019 年冠状病毒病（COVID-19）与流感季节同时爆发，对这两种传染病的临床特征进行了比较。我们在不同地点报告了 211 例 COVID-19 患者和 115 例流感患者，作为两个独立的队列。总结并比较了两个队列以及 COVID-19 队列中重症监护病房（ICU）和非 ICU 患者之间的人口统计学数据、病史、实验室检查结果和影像学特征。对于所有 326 例患者，中位年龄为 57.0（四分位距：45.0-69.0），48.2%为男性，43.9%合并有高血压、糖尿病、支气管炎和心脏病等合并症。患者有咳嗽（75.5%）、发热（69.3%）、咳痰（41.1%）、呼吸困难（19.3%）、胸痛（18.7%）和乏力（16.0%）等症状。两种病毒感染均导致明显的血液异常，而 COVID-19 组白细胞增多、中性粒细胞增多或淋巴细胞减少的频率较低，但肌酸激酶升高的可能性较高。总共有 7.7%的患者胸部计算机断层扫描（CT）扫描无异常表现。对于两种感染，影像学检查中肺部病变的位置和分布没有差异。然而，与流感组相比，COVID-19 组的 CT 特征更具多样性，某些特定的 CT 模式出现的频率更高，包括实变、铺路石征、圆形混浊、空气支气管征、树芽征、小叶间隔增厚和细支气管壁增厚。可区分的临床表现和 CT 模式可能有助于从流感中诊断 COVID-19，并更好地了解这两种传染性呼吸道疾病。
