scholarly journals Comparison of Clinical Features on Admission Between Coronavirus Disease 2019 and Influenza A among Children: A Retrospective Study in China

2020 ◽  
Author(s):  
Feng Liang ◽  
Xianfeng Wang ◽  
Hui Li ◽  
Jun Chen ◽  
Lei Liu ◽  
...  

Abstract Background: Coronavirus disease 2019 (COVID-19) share similar symptoms with influenza A (IA), but it is more worthwhile to understand the disparities of the two infections regarding their clinical characteristics on admission. Methods: A total of 71 age-matched pediatric IA and COVID-19 patient pairs were formed and their clinical data on admission were compared. Results: Fever, cough, nasal congestion and nausea/vomiting were the most common symptoms on admission for both infections but occurred less often in COVID-19. The IA patients were more likely to have lower-than-normal levels of lymphocyte count and percentage and to have higher-than-normal levels of activated partial thromboplastin time, prothrombin time, serum C-reactive protein, and serum procalcitonin, while the COVID-19 patients had higher odds of having lower-than-normal levels of neutrophil count and percentage.Conclusions: This study suggests that influenza A is more symptomatic than COVID-19 for children and might be an overall more severe infection at the time of admission.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Feng Liang ◽  
Xianfeng Wang ◽  
Jianbo Shao ◽  
Jun Chen ◽  
Lei Liu ◽  
...  

Abstract Background Coronavirus disease 2019 (COVID-19) share similar symptoms with influenza A (IA), but it is more worthwhile to understand the disparities of the two infections regarding their clinical characteristics on admission. Methods A total of 71 age-matched pediatric IA and COVID-19 patient pairs were formed and their clinical data on admission were compared. Results Fever, cough, nasal congestion and nausea/vomiting were the most common symptoms on admission for both infections but occurred less often in COVID-19. The IA patients were more likely to have lower-than-normal levels of lymphocyte count and percentage and to have higher-than-normal levels of activated partial thromboplastin time, prothrombin time, serum C-reactive protein, and serum procalcitonin, while the COVID-19 patients had higher odds of having lower-than-normal levels of neutrophil count and percentage. Conclusions This study suggests that influenza A is more symptomatic than COVID-19 for children and might be an overall more severe infection at the time of admission.


2020 ◽  
Author(s):  
Feng Liang ◽  
Xianfeng Wang ◽  
Hui Li ◽  
Jun Chen ◽  
Lei Liu ◽  
...  

Abstract Background: Coronavirus disease 2019 (COVID-19) share similar symptoms with influenza A (IA), but it is more worthwhile to understand the disparities of the two infections regarding their clinical characteristics on admission. Methods: A total of 71 age-matched pediatric IA and COVID-19 patient pairs were formed and their clinical data on admission were compared. Results: Fever, cough, nasal congestion and nausea/vomiting were the most common symptoms on admission for both infections but occurred less often in COVID-19. The IA patients were more likely to have lower-than-normal levels of lymphocyte count and percentage and to have higher-than-normal levels of activated partial thromboplastin time, prothrombin time, serum C-reactive protein, and serum procalcitonin, while the COVID-19 patients had higher odds of having lower-than-normal levels of neutrophil count and percentage. Conclusion: This study suggests that influenza A is more symptomatic than COVID-19 for children and might be an overall more severe infection at the time of admission.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Maria Cattelan ◽  
Eugenia Di Meco ◽  
Marco Trevenzoli ◽  
Alessia Frater ◽  
Anna Ferrari ◽  
...  

Abstract Background Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study offers a description of COVID-19 patients, admitted to a general ward for a non-critical clinical picture, with the aim to analyse the differences between those transferred to the intensive (ICU) and/or sub-intensive care (SICU) units and those who were not. Methods This observational retrospective study includes all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined as Group 1; patients who were transferred to the ICU and/or SICU are defined as Group 2. Demographic, clinical characteristics and laboratory findings at the 1st, 3rd and last measurements were compared between the two groups. Results 303 were included. The median age was 62 years. 69 patients (22.8%) met the primary outcome and were defined as Group 2. The overall fatality rate was 6.8%. Group 2 patients were predominantly male (76.8% vs. 55.1%, p < 0.01), had a higher fatality rate (14.5% vs. 3.8%, p < 0,01), had more hypertension (72.4% vs. 44%, p < 0,01) and diabetes (31.9% vs. 21%, p = 0.04) and were more likely to present dry cough (49.3% vs. 25.2%, p < 0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63.2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72.7% vs. 17.2%, p = 0.01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-Reactive-Protein. At the 3rd measurement, Group 2 presented persistently higher neutrophil count, hepatic inflammation markers and C-Reactive-Protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p < 0.01). Conclusions The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening.


2021 ◽  
Vol 13 ◽  
Author(s):  
Eugenia Irene Davidescu ◽  
Irina Odajiu ◽  
Delia Tulbǎ ◽  
Constantin Dragoş Sandu ◽  
Teodora Bunea ◽  
...  

Introduction: The emerging Coronavirus Disease (COVID-19) pandemic caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a serious public health issue due to its rapid spreading, high mortality rate and lack of specific treatment. Given its unpredictable clinical course, risk assessment, and stratification for severity of COVID-19 are required. Apart from serving as admission criteria, prognostic factors might guide future therapeutic strategies.Aim: We aimed to compare clinical features and biological parameters between elderly (age ≥ 65 years) and non-elderly (age &lt;65 years) patients with COVID-19 and new neurological symptoms/conditions. We also aimed to determine factors independently associated with all-cause in-hospital mortality.Methods: All consecutive patients with COVID-19 and new neurological symptoms/conditions admitted in our Neurology Department between April 1 and August 23, 2020 were enrolled in this observational retrospective cohort study. Patient characteristics such as demographic data, comorbidities, biological parameters, imaging findings and clinical course were recorded. All-cause in-hospital mortality was the main outcome, whereas COVID-19 severity, hospitalization duration and the levels of supplemental oxygen were the secondary outcomes.Results: One hundred forty-eight patients were included, out of which 54.1% were women. The average age was 59.84 ± 19.06 years and 47.3% were elderly, the majority having cardiovascular and metabolic comorbidities. In the elderly group, the most frequent neurological symptoms/manifestations responsible for hospitalization were stroke symptoms followed by confusion, whereas in the non-elderly, headache prevailed. The final neurological diagnosis significantly varied between the two groups, with acute cerebrovascular events and acute confusional state in dementia most commonly encountered in the elderly (65.71 and 14.28%, respectively) and secondary headache attributed to SARS-CoV-2 infection often experienced by the non-elderly (38.46%). The elderly had statistically significant higher median values of white blood cell (8,060 vs. 6,090/μL) and neutrophil count (6,060 vs. 4,125/μL), C-reactive protein (29.2 vs. 5.72 mg/L), ferritin (482 vs. 187 mg/dL), fibrinogen (477 vs. 374 mg/dL), D-dimer (1.16 vs. 0.42), prothrombin time (151.15 vs. 13.8/s), aspartate transaminase (26.8 vs. 20.8 U/l), creatinine (0.96 vs. 0.77 mg/dL), and blood urea nitrogen level (51.1 vs. 27.65 mg/dL), as well as lower median value of hemoglobin (13.05 vs. 13.9 g/dL) and lymphocyte count (1,245 vs. 1,670/μL). Moreover, advanced age was significantly associated with more extensive lung involvement (25 vs. 10%) and higher fatality rate (40 vs. 9%). Overall, the mortality rate was 23.6%. Age as well as neutrophil count, C-reactive protein, fibrinogen, and activated partial thromboplastin time levels were independently associated with mortality.Conclusions: Older age, higher neutrophil count, C-reactive protein, fibrinogen, and activated partial thromboplastin time levels are independent predictors of mortality in COVID-19 patients with new neurological manifestations/conditions at admission.


2020 ◽  
Author(s):  
Anna Maria Cattelan ◽  
Eugenia Di Meco ◽  
Marco Trevenzoli ◽  
Alessia Frater ◽  
Anna Ferrari ◽  
...  

Abstract Background Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study aims to offer a comparative description of the COVID-19 patients, admitted to a general ward for a non-critical clinical picture, who required or not to be transferred to the intensive (ICU) and/or sub-intensive care (SICU) units. Methods This observational retrospective study included all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined Group 1; patients who were transferred to the ICU and/or SICU are defined Group 2. Demographic and clinical characteristics were compared between the two groups. Results 303 patients were included. Median age was 62 years. 69 patients (22,8%) met the primary outcome and were defined Group 2. The overall mortality rate was 6.8%. Group 2 were more likely to be men, had a higher mortality (14,5% vs. 3,8%, p<0,01), had more hypertension (72,4% vs. 44%, p<0,01) and diabetes (31,9% vs. 21%, p=0,04) and were more likely to present dry cough (49,3% vs. 25,2%, p<0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63,2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72,7%vs. 17,2%, p<0,01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-reactive-protein. At the 3rd measurement, Group 2 presented persistently higher neutrophil count, liver function tests and C-reactive-protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p<0,01). Conclusions The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening.


2020 ◽  
Author(s):  
Anna Maria Cattelan ◽  
Eugenia Di Meco ◽  
Marco Trevenzoli ◽  
Alessia Frater ◽  
Anna Ferrari ◽  
...  

Abstract Background Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study offers a description of COVID-19 patients, admitted to a general ward for a non-critical clinical picture, with the aim to analyse the differences between those transferred to the intensive (ICU) and/or sub-intensive care (SICU) units and those who were not.Methods This observational retrospective study includes all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined as Group 1; patients who were transferred to the ICU and/or SICU are defined as Group 2. Demographic, clinical characteristics and laboratory findings at the 1st, 3rd and last measurements were compared between the two groups. Results 303 patients were included. The median age was 62 years. 69 patients (22.8%) met the primary outcome and were defined as Group 2. The overall fatality rate was 6.8%. Group 2 patients were predominantly male (76.8% vs. 55.1%, p<0.01), had a higher fatality rate (14.5% vs. 3.8%, p<0,01), had more hypertension (72.4% vs. 44%, p<0,01) and diabetes (31.9% vs. 21%, p=0.04) and were more likely to present dry cough (49.3% vs. 25.2%, p<0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63.2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72.7% vs. 17.2%, p=0.01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-reactive-protein. At the 3rd measurement, Group 2 presented persistently higher neutrophil count, hepatic inflammation markers and C-reactive-protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p<0.01). Conclusions The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening.


2020 ◽  
Author(s):  
Miri Hyun ◽  
Ji Yeon Lee ◽  
Jae Suck Park ◽  
Hyun Ah Kim

Abstract Background: The progression of coronavirus disease-2019 (COVID-19) is less well-studied in asymptomatic patients. The study aimed to understand the clinical characteristics of asymptomatic COVID-19 patients at the time of admission and follow-up their occurrence of symptoms during hospitalization.Methods: Patients were divided into two groups—those with no symptoms until discharge (group A) and those who had symptoms that developed during hospitalization (group B). Baseline and clinical characteristics were retrospectively measured, and logistic regression analysis was performed to identify risk factors for deterioration during hospital stay.Results: Overall, 223 patients were enrolled in the study, including 42 and 181 patients in groups A and B, respectively. Patients were older in group B than in group A. They developed cough as the most common symptom. Abnormal initial chest X-ray (CXR) and higher levels of C-reactive protein were frequently observed in group B than in group A. Moreover, 5 patients required mechanical support, including hi-flow nasal cannular and mechanical ventilation in group B. Five patients were transferred to tertiary hospitals owing to deterioration, and 4 patients succumbed to COVID-19. The risk factors for deterioration were age over 75 years, diabetes mellitus, and C-reactive protein > 1.Conclusions: Even when the patients have no symptoms at admission, we recommend close monitoring of symptoms during hospital stay in patients who present with risk factors at the time of admission.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Ghodsiyeh Azarkar ◽  
Freshteh Osmani

Abstract Background The coronavirus disease 2019(COVID-19) has affected mortality worldwide. The Cox proportional hazard (CPH) model is becoming more popular in time-to-event data analysis. This study aimed to evaluate the clinical characteristics in COVID-19 inpatients including (survivor and non-survivor); thus helping clinicians give the right treatment and assess prognosis and guide the treatment. Methods This single-center study was conducted at Hospital for COVID-19 patients in Birjand. Inpatients with confirmed COVID-19 were included. Patients were classified as the discharged or survivor group and the death or non-survivor group based on their outcome (improvement or death). Clinical, epidemiological characteristics, as well as laboratory parameters, were extracted from electronic medical records. Independent sample T test and the Chi-square test or Fisher’s exact test were used to evaluate the association of interested variables. The CPH model was used for survival analysis in the COVID-19 death patients. Significant level was set as 0.05 in all analyses. Results The results showed that the mortality rate was about (17.4%). So that, 62(17%) patients had died due to COVID-19, and 298 (83.6%) patients had recovered and discharged. Clinical parameters and comorbidities such as oxygen saturation, lymphocyte and platelet counts, hemoglobin levels, C-reactive protein, and liver and kidney function, were statistically significant between both studied groups. The results of the CPH model showed that comorbidities, hypertension, lymphocyte counts, platelet count, and C-reactive protein level, may increase the risk of death due to the COVID-19 as risk factors in inpatients cases. Conclusions Patients with, lower lymphocyte counts in hemogram, platelet count and serum albumin, and high C-reactive protein level, and also patients with comorbidities may have more risk for death. So, it should be given more attention to risk management in the progression of COVID-19 disease.


2021 ◽  
Vol 21 (3) ◽  
pp. 159-164
Author(s):  
Tamara N. Shvedova ◽  
Olga S. Kopteva ◽  
Polina A. Kudar ◽  
Anna A. Lerner ◽  
Yuliya A. Desheva

BACKGROUND: Despite the continuing global spread of the coronavirus infection COVID-19 caused by the SARS-CoV-2 coronavirus, the mechanisms of the pathogenesis of severe infections remain poorly understood. The role of comorbidity with other seasonal viral infections, including influenza, in the pathogenesis of the severe course of COVID-19 remains unclear. MATERIALS AND METHODS: The present study used sera left over from ongoing laboratory studies of patients with varying degrees of severity of COVID-19. The study was approved by the Local Ethics Committee of the Federal State Budgetary Scientific Institution IEM (protocol 3/20 from 06/05/2020). We studied 28 paired samples obtained upon admission of patients to the hospital and after 57 days of hospital stay. Paired sera of patients with COVID-19 were tested for antibodies to influenza A and B viruses. The presence of IgG antibodies specific to the SARS-CoV-2 spike (S) protein was studied using an enzyme-linked immunosorbent assay (ELISA). The serum concentration of C-reactive protein and the neutrophil-lymphocyte ratio on the day of hospitalization were also assessed. RESULTS: At least a 4-fold increase in serum IgG antibodies to SARS-CoV-2 S protein was found both in patients with PCR-confirmed SARS-CoV-2 infection and without PCR confirmation. It was shown that out of 18 patients with moderate and severe forms of COVID-19 infection, six of them showed at least a 4-fold increase in antibodies to influenza A/H1N1, in one to influenza A/H3N2 and in two cases to the influenza B. Laboratory data in these two groups were characterized by significant increases in serum C-reactive protein and neutrophil-lymphocyte ratio concentrations compared with the moderate COVID-19 group. CONCLUSIONS: Serological diagnostics can additionally detect cases of coronavirus infection when the virus was not detected by PCR. In moderate and severe cases of COVID-19, coinfections with influenza A and B viruses have been identified. The results obtained confirm the need for anti-influenza immunization during the SARS-CoV-2 pandemic. Influenza virus screening can significantly improve patient management because recommended antiviral drugs (neuraminidase inhibitors) are available.


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