Han Yingying, Wang Zhijia, Li Xingzhao, Zhong Zhuan
Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China, 130000, ORCID: 0000-0002-3583-0448.
Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China, 130000.
Int J Med Sci. 2025 Jan 13;22(3):641-650. doi: 10.7150/ijms.98194. eCollection 2025.
Coronavirus disease 2019 (COVID-19) and influenza are two infectious diseases that can pose a great threat to human health. We aimed to compare the differences in chest images between patients with COVID-19 and influenza to deepen the understanding of these two diseases. We searched PubMed, Embase and Web of Science for articles published before December 25, 2023, and performed a meta-analysis using Stata 14.0 with a random-effects model. The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twenty-six articles with 2,159 COVID-19 patients and 1,568 influenza patients were included in the meta-analysis. By comparing chest computed tomography (CT) and chest X-ray, we found that COVID-19 patients had more peripheral lung lesions (OR=3.66, 95% CI: 1.84-7.31). Although COVID-19 patients had more bilateral lung involvement (OR=1.74, 95% CI: 0.90-3.38) and less unilateral lung involvement (OR=0.67, 95% CI: 0.44-1.02), these two results were not statistically significant. Patients with COVID-19 showed more ground-glass opacities (OR=2.83, 95% CI: 1.85-4.32), reverse halo signs (OR=3.47, 95% CI: 2.37-5.08), interlobular septal thickening (OR=2.16, 95% CI: 1.55-3.01), vascular enlargement (OR=5.00, 95% CI: 1.80-13.85) and crazy-paving patterns (OR=2.63, 95% CI: 1.57-4.41) on chest images than patients with influenza. We also found that compared with influenza patients, pleural effusion was rare in COVID-19 patients (OR=0.15, 95% CI: 0.07-0.31). There are some differences in the manifestations and distributions of lesions between patients with COVID-19 and influenza on chest images, which is helpful to distinguish these two infectious diseases.
2019冠状病毒病（COVID-19）和流感是两种可能对人类健康构成重大威胁的传染病。我们旨在比较COVID-19患者和流感患者胸部影像的差异，以加深对这两种疾病的理解。我们在PubMed、Embase和Web of Science上检索了2023年12月25日前发表的文章，并使用Stata 14.0采用随机效应模型进行荟萃分析。该研究按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行。荟萃分析纳入了26篇文章，共2159例COVID-19患者和1568例流感患者。通过比较胸部计算机断层扫描（CT）和胸部X线，我们发现COVID-19患者的外周肺病变更多（OR=3.66，95%CI：1.84-7.31）。虽然COVID-19患者双侧肺受累更多（OR=1.74，95%CI：0.90-3.38），单侧肺受累更少（OR=0.67，95%CI：0.44-1.02），但这两个结果均无统计学意义。COVID-19患者胸部影像上的磨玻璃影（OR=2.83，95%CI：1.85-4.32）、反晕征（OR=3.47，95%CI：2.37-5.08）、小叶间隔增厚（OR=2.16，95%CI：1.55-3.01）、血管增粗（OR=5.00，95%CI：1.80-13.85）和铺路石样表现（OR=2.63，95%CI：1.57-4.41）比流感患者更多。我们还发现，与流感患者相比，COVID-19患者胸腔积液较少见（OR=0.15，95%CI：0.07-0.31）。COVID-19患者和流感患者胸部影像上病变的表现和分布存在一些差异，这有助于区分这两种传染病。
