Săsăran Maria Oana, Muntean Carmen Viorica, Stoica Andreea Bianca, Schwesig Carmen, Văsieșiu Anca Meda, Pleșca Anca Doina, Mărginean Cristina Oana
Department of Pediatrics 3, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Gheorghe Marinescu Street No. 38, 540136 Targu Mures, Romania.
Department of Pediatrics 1, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Gheorghe Marinescu Street No. 38, 540136 Targu Mures, Romania.
Life (Basel). 2025 May 14;15(5):784. doi: 10.3390/life15050784.
SARS-CoV-2 and influenza can present with similar clinical pictures in children, with symptoms and paraclinical particularities which might aid in the differentiation of the two entities and which can be suggestive of various complications. The present study aims to identify clinical and paraclinical differences between pediatric SARS-CoV-2 and influenza infection and to assess the utility of hematological parameters for prediction of their related complications.
In this study, 266 children were retrospectively enrolled, divided into two groups: 129 children diagnosed with SARS-CoV-2 infection and 137 children infected with influenza. In each case, particular symptoms were recorded, as well as hospitalization duration, pediatric intensive care unit (PICU) admission or O supplementation requirement. Parameters of the hemoleucogram and biochemistry parameters were also collected for comparative assessment.
SARS-CoV-2 infections were more commonly associated with digestive symptoms, whereas influenza infections implied longer hospital stays and higher likelihood of PICU admission necessity. Monocytes and lymphocyte/monocyte ratios (LMRs) were significantly higher in the SARS-CoV-2 group ( < 0.01, = 0.02). Several hematological parameters, such as neutrophil/lymphocyte ratios, correlated with hospitalization duration in SARS-CoV-2 and influenza B infections ( < 0.01, = 0.01), whereas LMR was predictive of respiratory distress ( = 0.02) in the same study groups.
According to the study, monocyte levels and LMR can aid in the distinction of pediatric SARS-CoV-2 and influenza infections and LMR and NLR can be used particularly as predictors of complicated course of these infections.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染和流感在儿童中可能呈现相似的临床表现，其症状和辅助检查特点可能有助于区分这两种疾病，也可能提示各种并发症。本研究旨在确定儿童SARS-CoV-2感染和流感感染在临床和辅助检查方面的差异，并评估血液学参数对预测其相关并发症的作用。
本研究回顾性纳入266名儿童，分为两组：129名诊断为SARS-CoV-2感染的儿童和137名感染流感的儿童。记录每种情况下的特殊症状、住院时间、儿科重症监护病房（PICU）收治情况或吸氧需求。还收集血常规和生化参数进行比较评估。
SARS-CoV-2感染更常伴有消化系统症状，而流感感染意味着更长的住院时间和更高的PICU收治必要性。SARS-CoV-2组的单核细胞及淋巴细胞/单核细胞比值（LMR）显著更高（<0.01，=0.02）。一些血液学参数，如中性粒细胞/淋巴细胞比值，与SARS-CoV-2和乙型流感感染的住院时间相关（<0.01，=0.01），而在同一研究组中，LMR可预测呼吸窘迫（=0.02）。
根据该研究，单核细胞水平和LMR有助于区分儿童SARS-CoV-2感染和流感感染，LMR和中性粒细胞/淋巴细胞比值（NLR）尤其可作为这些感染复杂病程的预测指标。
