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Chest. Comparison of Hospitalized Patients with Acute Respiratory Distress Syndrome Caused by COVID-19 and H1N1

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  • Chest. Comparison of Hospitalized Patients with Acute Respiratory Distress Syndrome Caused by COVID-19 and H1N1


    Chest. 2020 Mar 26. pii: S0012-3692(20)30558-4. doi: 10.1016/j.chest.2020.03.032. [Epub ahead of print]
    Comparison of Hospitalized Patients with Acute Respiratory Distress Syndrome Caused by COVID-19 and H1N1.


    Tang X1, Du R2, Wang R1, Cao T2, Guan L2, Yang C2, Zhu Q2, Hu M2, Li X1, Li Y1, Liang L1, Tong Z1, Sun B3, Peng P4, Shi H5.

    Author information




    Abstract

    BACKGROUND:

    Since the outbreak of Coronavirus Disease 2019 (COVID-19) in China in December 2019, considerable attention has been focused on its elucidation. However, it is also important for clinicians and epidemiologists to differentiate COVID-19 from other respiratory infectious diseases, such as influenza viruses.
    RESEARCH QUESTION:

    The aim of the study was to explore the different clinical presentations between COVID-19 and influenza A (H1N1) pneumonia in patients with acute respiratory distress syndrome (ARDS).
    STUDY DESIGN:

    and Methods: This was a retrospective case-control study. We compared two independent cohorts of ARDS patients infected with either COVID-19 (n=73) or H1N1 (n=75). We analyzed and compared their clinical manifestations, imaging characteristics, treatments, and prognosis.
    RESULTS:

    The median age of COVID-19 patients was higher than that of H1N1 patients, and there was a higher proportion of males among COVID-19 patients (p<0.05). COVID-19 patients exhibited higher proportions of non-productive coughs, fatigue, and gastrointestinal symptoms than those of H1N1 patients (p<0.05). H1N1 patients had higher sequential organ failure assessment (SOFA) scores than COVID-19 patients (p<0.05). The PaO2/FiO2 of 198.2 mmHg in COVID-19 patients was significantly higher than the PaO2/FiO2 of 107.0 mmHg of H1N1 patients (p<0.001). Ground-glass opacities was more common in COVID-19 patients than in H1N1 patients (p<0.001). There was a greater variety of antiviral therapies administered to COVID-19 patients than to H1N1 patients. The in-hospital mortality of COVID-19 patients was 28.8%, while that of H1N1 patients was 34.7% (p=0.483). SOFA-score adjusted mortality of H1N1 patients was significantly higher than that of COVID-19 patients with the rate ratio was 2.009 (95% CI [1.563, 2.583], p<0.001).
    INTERPRETATION:

    There were many differences between COVID-19 and H1N1-induced ARDS patients in clinical presentations. Compared with H1N1, patients with COVID-19 induced ARDS had lower severity of illness scores at presentation and lower SOFA-score adjusted mortality.
    Copyright ? 2020. Published by Elsevier Inc.



    KEYWORDS:

    COVID-19; acute respiratory distress syndrome; influenza A H1N1; mortality


    PMID:32224074DOI:10.1016/j.chest.2020.03.032

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