Yang Yutang, Zheng Qi, Yang Linlin, Wu Lei
Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250021, China.
Department of Gynecology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, 250013, China.
Heliyon. 2024 May 1;10(10):e30391. doi: 10.1016/j.heliyon.2024.e30391. eCollection 2024 May 30.
Influenza and COVID-19 patients share similar features and outcomes amongst adults. However, the difference between these diseases is not explored in paediatric age group especially in terms of inflammatory markers, coagulation profile and outcomes. Hence, we did this review to compare the inflammatory, coagulation features and outcomes between influenza and COVID-19 infected children.
Literature search was done in PubMed Central, Scopus, EMBASE, CINAHL, Cochrane library, Google Scholar & ScienceDirect from November 2019 to May 2022. Risk of bias assessment was done through Newcastle Ottawa scale. Meta-analysis was done using random-effects model and the final pooled estimate was reported as pooled odds ratio (OR) or standardized mean difference (SMD) along with 95 % confidence interval (CI) depending on the type of outcome.
About 16 studies were included with most studies having higher risk of bias. Influenza paediatric patients had significantly higher erythrocyte sedimentation rate (ESR) (pooled SMD = 0.60; 95%CI: 0.30-0.91; I = 0 %), lactate dehydrogenase (LDH) (pooled SMD = 2.01; 95%CI: 0.37-3.66; I = 98.4 %) and prothrombin time (PT) (pooled SMD = 2.12; 95%CI: 0.44-3.80; I = 98.3 %) when compared to paediatric COVID-19 patients. There was no significant difference in terms of features like CRP, procalcitonin, serum albumin, aPTT, mortality and need for mechanical ventilation.
Inflammatory markers like ESR, LDH and PT was significantly higher in influenza patients when compared to COVID-19 in children, while rest of the markers and adverse clinical outcomes were similar between both the groups. Identification of these biomarkers has helped in understanding the distinctness of COVID-19 and influenza virus and develop better management strategies.
在成人中，流感和新冠病毒感染患者具有相似的特征和预后。然而，在儿童年龄组中，尚未探讨这两种疾病之间的差异，尤其是在炎症标志物、凝血指标和预后方面。因此，我们进行了这项综述，以比较流感和新冠病毒感染儿童的炎症、凝血特征及预后。
于2019年11月至2022年5月在PubMed Central、Scopus、EMBASE、CINAHL、Cochrane图书馆、谷歌学术和ScienceDirect中进行文献检索。通过纽卡斯尔渥太华量表进行偏倚风险评估。采用随机效应模型进行荟萃分析，最终合并估计值报告为合并比值比（OR）或标准化均数差（SMD），并根据结局类型给出95%置信区间（CI）。
纳入了约16项研究，大多数研究存在较高的偏倚风险。与新冠病毒感染儿童相比，流感儿童患者的红细胞沉降率（ESR）（合并SMD = 0.60；95%CI：0.30 - 0.91；I² = 0%）、乳酸脱氢酶（LDH）（合并SMD = 2.01；95%CI：0.37 - 3.66；I² = 98.4%）和凝血酶原时间（PT）（合并SMD = 2.12；95%CI：0.44 - 3.80；I² = 98.3%）显著更高。在C反应蛋白、降钙素原、血清白蛋白、活化部分凝血活酶时间、死亡率和机械通气需求等特征方面，两组之间没有显著差异。
与儿童新冠病毒感染患者相比，流感患者的ESR、LDH和PT等炎症标志物显著更高，而两组之间的其他标志物和不良临床结局相似。识别这些生物标志物有助于了解新冠病毒和流感病毒的差异，并制定更好的管理策略。
