Medical features of COVID-19 and influenza infection: A comparative study in Paris, France

Faury, Hélène; Courboulès, Camille; Payen, Mathilde; Jary, Aude; Hausfater, Pierre; Luyt, Charles‐Édouard; Dres, Martin; Pourcher, Valérie; Abdi, Basma; Wirden, Marc; Cálvez, Vincent; Marcelin, Anne‐Geneviève; Boutolleau, David; Burrel, Sonia

doi:10.1016/j.jinf.2020.08.017

Cited by 31 publications

(49 citation statements)

References 7 publications

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“…Not only was the risk of complication higher, they also had a longer hospital LOS and considerably higher in-hospital mortality. These ndings have been reported by others and support the current notion of COVID-19 being a more hazardous condition than seasonal in uenza, at least for hospitalized patients [14,25].…”

Section: Discussionsupporting

confidence: 91%

Characteristics of Patients with Coronavirus Disease 2019 (COVID-19) and Seasonal Influenza at Time of Hospital Admission: a Single Center Comparative Study

Sieber

Flury

Güsewell

et al. 2021

Preprint

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BackgroundFor the winter season 2020/2021, co-circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza viruses A/B is expected. From a clinical point of view, differentiation of these two acute respiratory illnesses is crucial for optimal patient management. We therefore aimed to detect clinical differences between Coronavirus Disease 2019 (COVID-19) and seasonal influenza patients at time of hospital admission.MethodsIn this single-center observational study, we included all consecutive patients hospitalized for COVID-19 or influenza between November 2019 and May 2020. Data were extracted from a nationwide surveillance program and from electronic health records. COVID-19 and influenza patients were compared in terms of baseline characteristics, clinical presentation and outcome. We used recursive partitioning to generate a classification tree to discriminate COVID-19 from influenza patients.ResultsWe included 96 COVID-19 and 96 influenza patients. Median age was 68 vs. 70 years (p=0.90), 72% vs. 56% (p=0.024) were males, and median Charlson Comorbidity Index (CCI) was 1 vs. 2 (p=0.027) in COVID-19 and influenza patients, respectively. Time from symptom onset to hospital admission was longer for COVID-19 (median 7 days, IQR 3-10) than for influenza patients (median 3 days, IQR 2-5, p<0.001). Other variables favoring a diagnosis of COVID-19 in the classification tree were higher systolic blood pressure, lack of productive sputum, and lack of headache. The tree classified 86/192 patients (45%) into two subsets with ≥80% of patients having influenza or COVID-19, respectively. In-hospital mortality was higher for COVID-19 patients (16% vs. 5%, p=0.018).ConclusionDiscriminating COVID-19 from influenza patients based on clinical presentation is challenging. Time from symptom onset to hospital admission is considerably longer in COVID-19 than in influenza patients and showed the strongest discriminatory power in our classification tree. Although they had fewer comorbidities, in-hospital mortality was higher for COVID-19 patients.

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Section: Discussionsupporting

confidence: 91%

Characteristics of Patients with Coronavirus Disease 2019 (COVID-19) and Seasonal Influenza at Time of Hospital Admission: a Single Center Comparative Study

Sieber

Flury

Güsewell

et al. 2021

Preprint

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“…Fever and respiratory symptoms such as cough, expectoration or sputum production and dyspnea were the main symptoms in both groups with COVID-19 and influenza; however, they were significantly more frequent in patients with influenza [ 5 , 9 , 10 , 11 , 13 , 15 , 16 , 19 , 20 ]. Moreover, vomiting, otorhinolaryngological symptoms such as nasal congestion, rhinorrhea, sore throat and ocular symptoms such as tearing and conjunctival hyperhemia were statistically more frequent in patients with influenza than COVID-19 adult patients [ 5 , 10 , 11 , 12 , 15 ]. In patients infected with COVID-19, the most significant and frequent clinical features were fatigue, neurologic symptoms such as headache (especially facial headache: retro-orbital or frontal headache), anosmia and dysgeusia, gastro-intestinal (GI) symptoms such as diarrhea and acute respiratory distress syndrome (ARDS), compared to influenza patients [ 11 , 13 , 14 , 15 , 18 ].…”

Section: Resultsmentioning

confidence: 99%

“…In this review, 14 studies of 18 [ 5 , 6 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 18 , 19 , 20 , 21 ] reported a comparison between COVID-19 and influenza patients based on demographic findings, comorbidities, clinical features, and outcome ( Table 2 ). Fever and respiratory symptoms such as cough, expectoration or sputum production and dyspnea were the main symptoms in both groups with COVID-19 and influenza; however, they were significantly more frequent in patients with influenza [ 5 , 9 , 10 , 11 , 13 , 15 , 16 , 19 , 20 ]. Moreover, vomiting, otorhinolaryngological symptoms such as nasal congestion, rhinorrhea, sore throat and ocular symptoms such as tearing and conjunctival hyperhemia were statistically more frequent in patients with influenza than COVID-19 adult patients [ 5 , 10 , 11 , 12 , 15 ].…”

Section: Resultsmentioning

confidence: 99%

“…On PubMed, 331 articles were initially found, out of which 46 articles were selected. In the end, 18 articles were selected [3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] (8 retrospective studies, 6 cohort studies, 3 casecontrol studies, 1 prospective study, 1 cross-sectional study, 1 review and meta-analysis, and 1 review) ( Figure 1 and Table 1) An outcome-free study population is first identified by the exposure/event of interest and followed in time until the outcome of interest happens. They can be prospective (carried out from the present time into the future) or retrospective (carried out at the present time and look to the past to examine medical events or outcome).…”

Section: Included Citations In the Covid-19 Vs Influenza Reviewmentioning

confidence: 99%

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A Comparative Systematic Review of COVID-19 and Influenza

Osman

Klopfenstein

Belfeki³

et al. 2021

Viruses

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Background: Both SARS-CoV-2 and influenza virus share similarities such as clinical features and outcome, laboratory, and radiological findings. Methods: Literature search was done using PubMed to find MEDLINE indexed articles relevant to this study. As of 25 November 2020, the search has been conducted by combining the MeSH words “COVID-19” and “Influenza”. Results: Eighteen articles were finally selected in adult patients. Comorbidities such as cardiovascular diseases, diabetes, and obesity were significantly higher in COVID-19 patients, while pulmonary diseases and immunocompromised conditions were significantly more common in influenza patients. The incidence rates of fever, vomiting, ocular and otorhinolaryngological symptoms were found to be significantly higher in influenza patients when compared with COVID-19 patients. However, neurologic symptoms and diarrhea were statistically more frequent in COVID-19 patients. The level of white cell count and procalcitonin was significantly higher in influenza patients, whereas thrombopenia and elevated transaminases were significantly more common in COVID-19 patients. Ground-grass opacities, interlobular septal thickening, and a peripheral distribution were more common in COVID-19 patients than in influenza patients where consolidations and linear opacities were described instead. COVID-19 patients were significantly more often transferred to intensive care unit with a higher rate of mortality. Conclusions: This study estimated differences of COVID-19 and influenza patients which can help clinicians during the co-circulation of the two viruses.

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“…[4] In the UK, as the second wave is coinciding with the winter months, clinicians are faced with further complexity in the diagnosis of COVID-19 due to the similar symptomology with other viral respiratory illnesses. [5,6] Ensuring a detailed understanding of identi cation and management strategies adopted during the rst wave of infections is crucial in order to inform the design of effective clinical pathways for admitted patients. There is pressure to expedite test development and evaluation, and the demand on developing models to help identify optimal testing strategies is also high.…”

Section: Introductionmentioning

confidence: 99%

Care Pathway And Prioritization Of Rapid Testing For Covid-19 In UK Hospitals: A Qualitative Evaluation

Hicks

Winter

Green

et al. 2020

Preprint

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Objectives The second wave of the coronavirus pandemic is now established, occurring at a time of winter pressure on acute care in the NHS. This is likely to be more challenging then the first wave for the diagnosis of COVID-19 because of the similar symptomology with other respiratory conditions highly prevalent in winter. This study sought to understand the care pathways in place in UK NHS hospitals during the first wave (March-July 2020) for identification of patients with COVID-19 and to learn lessons to inform optimal testing strategies within the COVID-19 National Diagnostic Research and Evaluation Platform (CONDOR).Design, setting & participants Sixteen hospital-based clinicians from 12 UK NHS Trusts covering 10 different specialties were interviewed following a semi-structured topic guide. Data were coded soon after the interviews and analysed thematically.Results We developed a diagrammatic, high-level visualisation of the care pathway describing the main clinical decisions associated with the diagnosis and management of patients with suspected COVID-19. COVID-19 testing influenced infection control considerations more so than treatment decisions. Two main features of service provision influenced the patient management significantly: access to rapid laboratory testing and the number of single occupancy rooms. If time to return of result was greater than 24 hours, patients with a presumptive diagnosis would often be cohorted based on clinical suspicion alone. Undetected COVID-19 during this time could therefore lead to an increased risk of viral transmission.Conclusions During the winter months, priority for provision of rapid testing at admission should be given to hospitals with limited access to laboratory services and single room availability. Access to rapid testing is essential for urgent decisions related to emergency surgery, maternity services and organ transplant. The pathway and prioritization of need will inform the economic modelling, clinical evaluations, and implementation of new clinical tests in UK.

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Medical features of COVID-19 and influenza infection: A comparative study in Paris, France

Cited by 31 publications

References 7 publications

Characteristics of Patients with Coronavirus Disease 2019 (COVID-19) and Seasonal Influenza at Time of Hospital Admission: a Single Center Comparative Study

Characteristics of Patients with Coronavirus Disease 2019 (COVID-19) and Seasonal Influenza at Time of Hospital Admission: a Single Center Comparative Study

A Comparative Systematic Review of COVID-19 and Influenza

Care Pathway And Prioritization Of Rapid Testing For Covid-19 In UK Hospitals: A Qualitative Evaluation

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