Characteristics of patients with Coronavirus Disease 2019 (COVID-19) and seasonal influenza at time of hospital admission: a single center comparative study

BMC Infectious Diseases

Sabine Güsewell¹  Katia Boggian²  Pietro Vernazza²  Pablo Sieber²  Domenica Flury²  Werner C. Albrich²  Philipp Kohler²  Matthias Schlegel²  Robert Sieber³  Céline Gardiol⁴ 

[1] Clinical Trial Unit, Cantonal Hospital St. Gallen, St. Gallen, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, Rorschacher Strasse 95, 9007, St. Gallen, Switzerland;Emergency Department, Cantonal Hospital St. Gallen, St. Gallen, Switzerland;Federal Office of Public Health, Berne, Switzerland;

关键词: COVID-19;    SARS-CoV-2;    Influenza;    Differences;    Comparative;    Classification tree;   

DOI  :  10.1186/s12879-021-05957-4

来源: Springer

【 摘 要 】

BackgroundIn the future, co-circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza viruses A/B is likely. From a clinical point of view, differentiation of the two disease entities is crucial for patient management. We therefore aim 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.

【 授权许可】

CC BY