Does Covid‐19 in children have a milder course than Influenza?

Abstract

Background In December 2019, a novel type of coronavirus infection emerged in the Wuhan province of China and began to spread rapidly. In this study, we aimed to determine the differences between COVID‐19 disease and Influenza. Methods This retrospective study included 164 children with COVID‐19, as well as 46 children with Influenza. The two groups were compared with respect to clinical and laboratory parameters and the rates of intensive care and mechanical ventilation requirement. Results In both groups, the most common admission complaints were fever and cough. As compared to the COVID‐19 group, the Influenza group had significantly higher rates of cough (37 [80.4%] and 38 [23.2%]), fever (31 [67.4%] and 34 [20.7%]), muscle pain (34 [73.9%] and 31 [18.9%]), vomiting (13 [28.9%] and 8 [4.9%]) and tachypnea (32 [69.6%] and 3 [1.8%]) ( P < .01 for all comparisons). The mean WBC count (7.10 ± 1.08 vs. 10.90 ± 1.82), mean neutrophil count (3.19 ± 0.58 vs. 6.04 ± 0.97), APTT, CRP, procalcitonin, ALT, and LDH levels were significantly lower in the COVID‐19 group compared to the Influenza group ( P < .05 for all comparisons). There was, however, no significant difference between the mean lymphocyte counts of both groups. The Influenza group had significantly higher rates of intensive care requirement (19 [41.3%] vs. 3 [1.8%]) and mechanical ventilation requirement (16 [34.8%] vs. 2 [1.2%]) as well as a significantly higher mortality rate (7 [15.2%] vs. 2 [1.2%]) than the COVID‐19 group ( P < .01). Conclusion COVID‐19 and Influenza may share similar clinical features. According to our findings, however, we believe that COVID‐19 disease has a milder clinical and laboratory course than Influenza in children.

Comparison of the Clinical and Laboratory Features of Covid and Influenza in Children

“…Some studies reported lower neutrophils in the COVID-19 pediatric groups, 11 , 16 , 19 like that observed in adulthood. 26 …”

“… 17 , 21 Some studies described lower neutrophil count in the COVID-19 group than in the Influenza group. 11 , 16 , 19 Zhao et al showed higher lymphocyte count in children with COVID-19, 10 while lymphocytopenia was more frequent in children with Influenza. 17 , 19 , 21 …”

“…Almost all studies reported significantly lower levels of C-reactive protein and procalcitonin in the COVID-19 group than in the Influenza group. 10 , 11 , 16 , 17 , 19 …”

“… 12 , 19 Indeed, children with Influenza were characterized by a higher rate of hospitalization duration, need for intensive care, oxygen therapy, ventilatory support, and mortality than those with COVID-19. 10 , 11 , 16 , 17 …”

“…Finally, 1 manuscript was added after the editor's revision. A total of 12 articles were included: [10][11][12][13][14][15][16][17][18][19][20][21] 8 retrospective studies, 2 cohort studies, 1 cross-sectional study, and 1 case-control study (Table 1).…”