Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
Department of Anesthesia and Critical Care Medicine, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
Infection. 2021 Oct;49(5):965-975. doi: 10.1007/s15010-021-01624-7. Epub 2021 May 26.
Little is known in distinguishing clinical features and outcomes between coronavirus disease-19 (COVID-19) and influenza (FLU).
MATERIALS/METHODS: Retrospective, single-centre study including patients with COVID-19 or FLU pneumonia admitted to the Intensive care Unit (ICU) of Policlinico Umberto I (Rome). Aims were: (1) to assess clinical features and differences of patients with COVID-19 and FLU, (2) to identify clinical and/or laboratory factors associated with FLU or COVID-19 and (3) to evaluate 30-day mortality, bacterial superinfections, thrombotic events and invasive pulmonary aspergillosis (IPA) in patients with FLU versus COVID-19.
Overall, 74 patients were included (19, 25.7%, FLU and 55, 74.3%, COVID-19), median age 67 years (58-76). COVID-19 patients were more male (p = 0.013), with a lower percentage of COPD (Chronic Obstructive Pulmonary Disease) and chronic kidney disease (CKD) (p = 0.001 and p = 0.037, respectively) than FLU. SOFA score was higher (p = 0.020) and lymphocytes were significantly lower in FLU than in COVID-19 [395.5 vs 770.0 cells/mmc, p = 0.005]. At multivariable analysis, male sex (OR 6.1, p < 0.002), age > 65 years (OR 2.4, p = 0.024) and lymphocyte count > 725 cells/mmc at ICU admission (OR 5.1, p = 0.024) were significantly associated with COVID-19, whereas CKD and COPD were associated with FLU (OR 0.1 and OR 0.16, p = 0.020 and p < 0.001, respectively). No differences in mortality, bacterial superinfections and thrombotic events were observed, whereas IPA was mostly associated with FLU (31.5% vs 3.6%, p = 0.0029).
In critically ill patients, male sex, age > 65 years and lymphocytes > 725 cells/mmc are related to COVID-19. FLU is associated with a significantly higher risk of IPA than COVID-19.
对于新型冠状病毒肺炎（COVID-19）和流感（FLU），人们对其临床特征和结局的区分知之甚少。
材料/方法：这是一项回顾性、单中心研究，纳入了因 COVID-19 或 FLU 肺炎入住罗马乌姆贝托一世综合医院（Policlinico Umberto I）重症监护病房（ICU）的患者。研究目的包括：（1）评估 COVID-19 与 FLU 患者的临床特征和差异；（2）确定与 FLU 或 COVID-19 相关的临床和/或实验室因素；（3）评估与 COVID-19 相比，FLU 患者的 30 天死亡率、细菌合并感染、血栓事件和侵袭性肺曲霉病（IPA）。
共纳入 74 例患者（19 例，25.7%，FLU；55 例，74.3%，COVID-19），中位年龄 67 岁（58-76 岁）。与 FLU 相比，COVID-19 患者中男性更多（p=0.013），COPD 和慢性肾脏病（CKD）的比例更低（p=0.001 和 p=0.037）。COVID-19 患者 SOFA 评分更高（p=0.020），淋巴细胞计数明显更低[395.5 与 770.0 细胞/mmc，p=0.005]。多变量分析显示，男性（OR 6.1，p<0.002）、年龄>65 岁（OR 2.4，p=0.024）和 ICU 入院时淋巴细胞计数>725 细胞/mmc（OR 5.1，p=0.024）与 COVID-19 显著相关，而 CKD 和 COPD 与 FLU 相关（OR 0.1 和 OR 0.16，p=0.020 和 p<0.001）。两组间死亡率、细菌合并感染和血栓事件无差异，但 IPA 主要与 FLU 相关（31.5%与 3.6%，p=0.0029）。
在危重症患者中，男性、年龄>65 岁和淋巴细胞计数>725 细胞/mmc 与 COVID-19 相关。FLU 与 IPA 的风险显著高于 COVID-19。
