Department of Pulmonology, University of Health Sciences, Yedikule Chest Disease and Surgery Training and Research Hospital, Pulmonology, Istanbul, Turkey.
J Med Virol. 2021 Dec;93(12):6619-6627. doi: 10.1002/jmv.27218. Epub 2021 Jul 29.
Both severe acute respiratory syndrome coronavirus 2 and influenza viruses cause similar clinical presentations. It is essential to assess severely ill patients presenting with a viral syndrome for diagnostic and prognostic purposes. We aimed to compare clinical and biochemical features between pneumonia patients with coronavirus disease 2019 (COVID-19) and H1N1. Sixty patients diagnosed with COVID-19 pneumonia and 61 patients diagnosed with influenza pneumonia were hospitalized between October 2020-January 2021 and October 2017-December 2019, respectively. All the clinical data and laboratory results, chest computed tomography scans, intensive care unit admission, invasive mechanical ventilation, and outcomes were retrospectively evaluated. The median age was 65 (range 32-96) years for patients with a COVID-19 diagnosis and 58 (range 18-83) years for patients with influenza (p = 0.002). The comorbidity index was significantly higher in patients with COVID-19 (p = 0.010). Diabetes mellitus and hypertension were statistically significantly more common in patients with COVID-19 (p = 0.019, p = 0.008, respectively). The distribution of severe disease and mortality was not significantly different among patients with COVID-19 than influenza patients (p = 0.096, p = 0.049).). In comparison with inflammation markers; C-reactive protein (CRP) levels were significantly higher in influenza patients than patients with COVID-19 (p = 0.033). The presence of sputum was predictive for influenza (odds ratio [OR] 0.342 [95% confidence interval [CI], 2.1.130-0.899]). CRP and platelet were also predictive for COVID-19 (OR 4.764 [95% CI, 1.003-1.012] and OR 0.991 [95% CI 0.984-0.998], respectively. We conclude that sputum symptoms by itself are much more detected in influenza patients. Besides that, lower CRP and higher PLT count would be discriminative for COVID-19.
新型冠状病毒和流感病毒都会引起类似的临床症状。因此,有必要对出现病毒性综合征的重症患者进行评估,以便明确诊断和判断预后。本研究旨在比较 2020 年 10 月至 2021 年 1 月间收治的新型冠状病毒肺炎(COVID-19)患者和 2017 年 10 月至 2019 年 12 月间收治的甲型 H1N1 流感肺炎患者的临床和生化特征。
分别纳入 60 例 COVID-19 肺炎患者和 61 例流感肺炎患者,对其临床资料、实验室结果、胸部 CT、入住重症监护病房(ICU)、有创机械通气及转归等进行回顾性分析。
COVID-19 患者的中位年龄为 65(3296)岁,流感患者的中位年龄为 58(1883)岁(P=0.002)。COVID-19 患者的合并症指数显著高于流感患者(P=0.010)。糖尿病和高血压在 COVID-19 患者中更为常见(P=0.019,P=0.008)。COVID-19 患者与流感患者的重症疾病和死亡率分布无显著差异(P=0.096,P=0.049)。与炎症标志物相比,流感患者的 C 反应蛋白(CRP)水平显著高于 COVID-19 患者(P=0.033)。咳痰是流感的预测因素(比值比 [OR] 0.342 [95%置信区间 [CI] 2.1.1300.899])。CRP 和血小板计数也可预测 COVID-19(OR 4.764 [95%CI 1.0031.012] 和 OR 0.991 [95%CI 0.984~0.998])。
综上,咳痰在流感患者中更为常见。此外,CRP 降低和血小板计数升高有助于 COVID-19 的诊断。