Int J Infect Dis

. 2020 Jun 11;S1201-9712(20)30462-8.
doi: 10.1016/j.ijid.2020.06.026. Online ahead of print.
Comparison of Hospitalized Patients With Pneumonia Caused by COVID-19 and Influenza A in Children Under 5 Years

Ying Li 1 , Haizhou Wang 2 , Fan Wang 2 , Hui Du 1 , Xueru Liu 1 , Peng Chen 1 , Yanli Wang 1 , Xiaoxia Lu 3

AffiliationsFree PMC article


Background: Since the outbreak of Coronavirus Disease 2019 (COVID-19) in Wuhan, considerable attention has been paid on its epidemiology and clinical characteristics in children patients. However, it is also crucial for clinicians to differentiate COVID-19 from other respiratory infectious diseases, such as influenza viruses.
Methods: This was a retrospective study. Two group of COVID-19 patients (n=57) and influenza A patients (n=59) were enrolled. We analyzed and compared their clinical manifestations, imaging characteristics and treatments.
Results: The proportions of cough (70.2%), fever (54.4%) and gastrointestinal symptoms (14.1%) in COVID-19 patients were lower than those of influenza A patients (98.3%, P<0.001; 84.7%, P<0.001; and 35.6%, P=0.007; respectively). In addition, COVID-19 patients showed significantly lower levels of leukocytes (7.87 vs. 9.89?109/L, P=0.027), neutrophils (2.43 vs. 5.16?109/L, P<0.001), C-reactive protein (CRP; 3.7 vs. 15.1mg/L, P=0.001) and procalcitonin (PCT; 0.09 vs. 0.68mm/h, P<0.001), while lymphocyte levels (4.58 vs. 3.56?109/L; P=0.006) were significantly higher compared with influenza A patients. In terms of CT imaging, ground-glass opacification in chest CT was more common in COVID-19 patients than in influenza A patients (42.1% vs. 15%, P=0.032). In contrast, consolidation was more common in influenza A patients (25%) than that in COVID-19 patients (5.2%, P=0.025).
Conclusion: The clinical manifestations and laboratory tests of COVID-19 children are milder than those of influenza A children under 5 years. Additionally, imaging results more commonly presented as ground-glass opacities in COVID-19 patients.

Keywords: COVID-19; Child; Influenza A; Pneumonia; SARS-CoV-2.