Department of Respiratory and Critical Care Medicine, Fujian Shengli Medical College, Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China.
Department of Hematology, Quanzhou First Hospital, Quanzhou, China.
Front Cell Infect Microbiol. 2023 Jul 18;13:1179552. doi: 10.3389/fcimb.2023.1179552. eCollection 2023.
This study explored the differences in clinical characteristics between the 2009 pandemic influenza A (H1N1) and SARS-CoV-2 BA.2 variant (Omicron) infections in patients younger than age 65 years, to improve identification of these diseases and better respond to the current epidemic.
Data from 127 patients with the 2009 pandemic influenza A (H1N1) diagnosed between May and July of 2009 and 3,265 patients with Omicron diagnosed between March and May of 2022 were collected. Using a 1:2 match based on age (difference <2 years), sex, and underlying diseases, data from 115 patients with the 2009 pandemic influenza A (H1N1) infection (H1N1 group) and 230 patients with SARS-CoV-2 Omicron BA.2 infection (Omicron group) were analyzed. The clinical manifestations were compared between the groups, logistic regression was performed to identify possible independent risk factors for each group, and multiple linear regression was used to analyze the factors predicting time for nucleic acid negativization (NAN).
The median [interquartile range] age of the two groups was 21 [11, 26] years. Compared with the H1N1 group, the Omicron group had: lower white blood cell counts and C-reactive protein levels; less fever, nasal congestion, sore throat, cough, sputum, and headache; and more olfactory loss, muscle soreness, and lactate dehydrogenase (LDH) abnormalities. Patients in the Omicron group used fewer antibiotics and antiviral drugs, and the time for NAN was longer (17 [14,20] VS 4 [3,5] days, P<0.001). Logistic regression showed that fever, cough, headache, and increased white blood cell count were more strongly correlated with the H1N1 group, while muscle soreness and LDH abnormalities were more strongly correlated with the Omicron group. Fever (B 1.529, 95% confidence interval [0.149,2.909], P=0.030) significantly predicted a longer time for NAN in patients with Omicron.
There are significant differences in clinical characteristics between SARS-CoV-2 Omicron infection and the 2009 pandemic influenza A (H1N1) infection. Recognition of these differences has important implications for clinical practice.
本研究旨在探讨年龄<65 岁的患者中 2009 年甲型 H1N1 流感（H1N1）和 SARS-CoV-2 BA.2 变异株（Omicron）感染的临床特征差异，以提高对这些疾病的识别能力，并更好地应对当前的疫情。
收集了 2009 年 5 月至 7 月期间确诊的 127 例 2009 年甲型 H1N1 流感患者和 2022 年 3 月至 5 月期间确诊的 3265 例 Omicron 患者的数据。采用基于年龄（<2 岁）、性别和基础疾病的 1:2 匹配，分析了 115 例 2009 年甲型 H1N1 流感（H1N1 组）和 230 例 SARS-CoV-2 Omicron BA.2 感染（Omicron 组）患者的临床特征。比较两组之间的临床表现，进行逻辑回归分析以确定每组的可能独立危险因素，并进行多元线性回归分析以分析预测核酸阴转时间（NAN）的因素。
两组患者的中位（四分位距）年龄分别为 21（11，26）岁。与 H1N1 组相比，Omicron 组白细胞计数和 C 反应蛋白水平较低；发热、鼻塞、咽痛、咳嗽、咳痰和头痛较少；嗅觉丧失、肌肉酸痛和乳酸脱氢酶（LDH）异常更多。Omicron 组患者使用的抗生素和抗病毒药物较少，NAN 时间较长（17[14，20]VS4[3，5]天，P<0.001）。逻辑回归显示，发热、咳嗽、头痛和白细胞计数增加与 H1N1 组相关性更强，而肌肉酸痛和 LDH 异常与 Omicron 组相关性更强。发热（B 1.529，95%置信区间[0.149，2.909]，P=0.030）显著预测 Omicron 患者的 NAN 时间更长。
SARS-CoV-2 Omicron 感染与 2009 年甲型 H1N1 流感（H1N1）感染的临床特征存在显著差异。认识到这些差异对临床实践具有重要意义。
