tetano
Editor, Senior Moderator
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 X[SUP]1[/SUP], Du R[SUP]2[/SUP], Wang R[SUP]1[/SUP], Cao T[SUP]2[/SUP], Guan L[SUP]2[/SUP], Yang C[SUP]2[/SUP], Zhu Q[SUP]2[/SUP], Hu M[SUP]2[/SUP], Li X[SUP]1[/SUP], Li Y[SUP]1[/SUP], Liang L[SUP]1[/SUP], Tong Z[SUP]1[/SUP], Sun B[SUP]3[/SUP], Peng P[SUP]4[/SUP], Shi H[SUP]5[/SUP].
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 PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] of 198.2 mmHg in COVID-19 patients was significantly higher than the PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] 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
Comparison of Hospitalized Patients with Acute Respiratory Distress Syndrome Caused by COVID-19 and H1N1.
Tang X[SUP]1[/SUP], Du R[SUP]2[/SUP], Wang R[SUP]1[/SUP], Cao T[SUP]2[/SUP], Guan L[SUP]2[/SUP], Yang C[SUP]2[/SUP], Zhu Q[SUP]2[/SUP], Hu M[SUP]2[/SUP], Li X[SUP]1[/SUP], Li Y[SUP]1[/SUP], Liang L[SUP]1[/SUP], Tong Z[SUP]1[/SUP], Sun B[SUP]3[/SUP], Peng P[SUP]4[/SUP], Shi H[SUP]5[/SUP].
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 PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] of 198.2 mmHg in COVID-19 patients was significantly higher than the PaO[SUB]2[/SUB]/FiO[SUB]2[/SUB] 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