Kim Si-Ho, Wi Yu Mi, Lim Sujin, Han Kil-Tae, Bae In-Gyu
Division of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, Korea.
Department of Pulmonology Diseases, Gyeongsangnam-do Masan Medical Center, Changwon 51264, Korea.
Diagnostics (Basel). 2021 Feb 8;11(2):261. doi: 10.3390/diagnostics11020261.
Concerns are arising about the simultaneous occurrence of the coronavirus disease 2019 (COVID-19) pandemic and the influenza epidemic, the so-called "twindemic". In this study, we compared clinical characteristics and chest images from patients with COVID-19 and influenza.
We conducted a case-control study of COVID-19 and age- and sex-matched influenza patients. Clinical characteristics and chest imaging findings between patients with COVID-19 and matched influenza patient controls were compared.
A total of 47 patients were enrolled in each group. Anosmia (14.9%) and ageusia (21.3%) were only observed in COVID-19 patients. There were 31 (66%) and 23 (48.9%) patients with COVID-19 and influenza who had pulmonary lesions confirmed by chest computed tomography (CT), respectively. The interval between symptom onset and pneumonia was significantly longer in patients with COVID-19. Round opacities were more common in images from COVID-19 patients (41.9% vs. 8.7%, = 0.007), whereas pure consolidation (0% vs. 34.9%, < 0.001) and pleural effusion (0% vs. 17.4%, = 0.028) were more common in images from influenza patients. Notably, the difference in the number of involved pulmonary lobes observed on CT and pulmonary fields observed on radiographic images was significantly higher in COVID-19-associated pneumonia than that in influenza-associated pneumonia (2.32 ± 1.14 vs. 1.48 ± 0.99, = 0.010).
Chest images and thorough review of clinical findings could provide value for proper differential diagnoses of COVID-19 patients, but they are not sufficiently sensitive for initial diagnoses. In addition, chest radiography could underestimate COVID-19 lung involvement because of the lesion characteristics of COVID-19-associated pneumonia.
新型冠状病毒肺炎（COVID-19）大流行与流感疫情同时出现，即所谓的“双流行”，引发了人们的关注。在本研究中，我们比较了COVID-19患者和流感患者的临床特征及胸部影像。
我们对COVID-19患者以及年龄和性别匹配的流感患者进行了病例对照研究。比较了COVID-19患者与匹配的流感患者对照的临床特征和胸部影像学表现。
每组共纳入47例患者。嗅觉丧失（14.9%）和味觉丧失（21.3%）仅在COVID-19患者中观察到。分别有31例（66%）COVID-19患者和23例（48.9%）流感患者经胸部计算机断层扫描（CT）证实有肺部病变。COVID-19患者症状出现至肺炎的间隔时间明显更长。圆形模糊影在COVID-19患者的影像中更常见（41.9%对8.7%，P = 0.007），而单纯实变（0%对34.9%，P < 0.001）和胸腔积液（0%对17.4%，P = 0.028）在流感患者的影像中更常见。值得注意的是，COVID-19相关肺炎在CT上观察到的受累肺叶数量和在X线胸片上观察到的肺野差异明显高于流感相关肺炎（2.32±1.14对1.48±0.99，P = 0.010）。
胸部影像和对临床发现的全面评估可为COVID-19患者的正确鉴别诊断提供价值，但对初始诊断的敏感性不足。此外，由于COVID-19相关肺炎的病变特征，胸部X线摄影可能低估COVID-19肺部受累情况。
