Department of Medicine, Cook County Health Sciences, Chicago, IL, USA.
Department of Medicine, Ziauddin Medical University, Karachi, Pakistan.
BMC Med. 2020 Dec 18;18(1):403. doi: 10.1186/s12916-020-01816-2.
Due to the overlapping clinical features of coronavirus disease 2019 (COVID-19) and influenza, parallels are often drawn between the two diseases. Patients with pre-existing cardiovascular diseases (CVD) are at a higher risk for severe manifestations of both illnesses. Considering the high transmission rate of COVID-19 and with the seasonal influenza approaching in late 2020, the dual epidemics of COVID-19 and influenza pose serious cardiovascular implications. This review highlights the similarities and differences between influenza and COVID-19 and the potential risks associated with coincident pandemics.
COVID-19 has a higher mortality compared to influenza with case fatality rate almost 15 times more than that of influenza. Additionally, a significantly increased risk of adverse outcomes has been noted in patients with CVD, with ~ 15 to 70% of COVID-19 related deaths having an underlying CVD. The critical care need have ranged from 5 to 79% of patients hospitalized due to COVID-19, a proportion substantially higher than with influenza. Similarly, the frequency of vascular thrombosis including deep venous thrombosis and pulmonary embolism is markedly higher in COVID-19 patients compared with influenza in which vascular complications are rarely seen. Unexpectedly, while peak influenza season is associated with increased cardiovascular hospitalizations, a decrease of ~ 50% in cardiovascular hospitalizations has been observed since the first diagnosed case of COVID-19, owing in part to deferred care.
In the coming months, increasing efforts towards evaluating new interventions will be vital to curb COVID-19, especially as peak influenza season approaches. Currently, not enough data exist regarding co-infection of COVID-19 with influenza or how it would progress clinically, though it may cause a significant burden on an already struggling health care system. Until an effective COVID-19 vaccination is available, high coverage of influenza vaccination should be of utmost priority.
由于 2019 年冠状病毒病（COVID-19）和流感的临床特征重叠，因此常将这两种疾病进行比较。患有心血管疾病（CVD）的患者罹患这两种疾病的严重表现的风险更高。考虑到 COVID-19 的高传播率，以及 2020 年末即将到来的季节性流感，COVID-19 和流感的双重流行对心血管系统产生了严重影响。本综述重点介绍了流感和 COVID-19 之间的相似之处和不同之处，以及同时发生大流行时的潜在风险。
与流感相比，COVID-19 的死亡率更高，病死率几乎是流感的 15 倍。此外，患有 CVD 的患者发生不良结局的风险显著增加，COVID-19 相关死亡中有 15%至 70%存在潜在 CVD。由于 COVID-19 住院的患者中需要重症监护的比例从 5%到 79%不等，这一比例远高于流感。同样，COVID-19 患者的血管血栓形成（包括深静脉血栓形成和肺栓塞）的频率明显高于流感，在流感中很少见血管并发症。出乎意料的是，尽管流感高发季节与心血管系统住院人数增加有关，但自首例 COVID-19 确诊以来，心血管系统住院人数减少了约 50%，部分原因是推迟了治疗。
在未来几个月中，评估新干预措施的努力对于遏制 COVID-19 至关重要，尤其是在即将到来的流感高发季节。目前，关于 COVID-19 与流感的合并感染或其临床进展情况的数据不足，但这可能会给已经不堪重负的医疗保健系统带来重大负担。在有效的 COVID-19 疫苗问世之前，应高度优先考虑流感疫苗的高覆盖率。
