State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Int J Infect Dis. 2022 Dec;125:278-284. doi: 10.1016/j.ijid.2022.11.008. Epub 2022 Nov 9.
This study aimed to investigate the differences between elderly patients hospitalized with COVID-19 or influenza A H1N1 virus infections.
We contrasted two absolute groups of patients (age ≥60 years) infected with either COVID-19 (n = 222) or influenza A H1N1 virus infections (n = 96). Propensity score matching was used to reduce the imbalance between the two matched groups. The clinical features, imaging presentations, therapies, and prognosis data were compared between the two groups.
The patients with influenza showed higher proportions of cough, expectoration, fatigue, and shortness of breath. Higher counts of lymphocytes, hemoglobin, and creatine kinase and lower counts of white blood cells, neutrophils, blood urea nitrogen, and C-reactive protein were found in the patients with COVID-19. Regarding the imaging characteristics, bilateral pneumonia was the most abnormal pattern in the two groups of patients. The incidence of acute respiratory distress syndrome or death was lower among the patients with COVID-19.
The clinical manifestations of patients with COVID-19 are more concealed than those of patients with influenza. Fewer symptoms of sputum production, fatigue, and shortness of breath, combined with lower counts of white blood cells, neutrophils, and C-reactive protein are the possible predictive factors of COVID-19 among elderly patients.
本研究旨在探讨老年 COVID-19 与甲型 H1N1 流感病毒感染住院患者之间的差异。
我们对比了两组绝对的老年患者（年龄≥60 岁），一组感染 COVID-19（n=222），另一组感染甲型 H1N1 流感病毒（n=96）。采用倾向评分匹配来减少两组匹配患者之间的不平衡。比较两组患者的临床特征、影像学表现、治疗和预后数据。
流感患者咳嗽、咳痰、乏力、气促的比例较高。COVID-19 患者的淋巴细胞、血红蛋白和肌酸激酶计数较高，白细胞、中性粒细胞、血尿素氮和 C 反应蛋白计数较低。在影像学特征方面，两组患者均以双侧肺炎最为常见。COVID-19 患者发生急性呼吸窘迫综合征或死亡的比例较低。
COVID-19 患者的临床表现比流感患者更为隐匿。咳痰、乏力、气促等症状较少，白细胞、中性粒细胞和 C 反应蛋白计数较低，可能是老年 COVID-19 患者的预测因素。
