tetano
Editor, Senior Moderator
Infection
. 2021 May 26.
doi: 10.1007/s15010-021-01624-7. Online ahead of print.
Comparison of clinical features and outcomes in COVID-19 and influenza pneumonia patients requiring intensive care unit admission
A Oliva[SUP] #[/SUP][SUP] 1 [/SUP], G Ceccarelli[SUP] #[/SUP][SUP] 2 [/SUP], C Borrazzo[SUP] 2 [/SUP], M Ridolfi[SUP] 2 [/SUP], G D 'Ettorre[SUP] 2 [/SUP], F Alessandri[SUP] 3 [/SUP], F Ruberto[SUP] 3 [/SUP], F Pugliese[SUP] 3 [/SUP], G M Raponi[SUP] 2 [/SUP], A Russo[SUP] 2 [/SUP], A Falletta[SUP] 2 [/SUP], C M Mastroianni[SUP] 2 [/SUP], M Venditti[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Little is known in distinguishing clinical features and outcomes between coronavirus disease-19 (COVID-19) and influenza (FLU).
Materials/methods: Retrospective, single-centre study including patients with COVID-19 or FLU pneumonia admitted to the Intensive care Unit (ICU) of Policlinico Umberto I (Rome). Aims were: (1) to assess clinical features and differences of patients with COVID-19 and FLU, (2) to identify clinical and/or laboratory factors associated with FLU or COVID-19 and (3) to evaluate 30-day mortality, bacterial superinfections, thrombotic events and invasive pulmonary aspergillosis (IPA) in patients with FLU versus COVID-19.
Results: Overall, 74 patients were included (19, 25.7%, FLU and 55, 74.3%, COVID-19), median age 67 years (58-76). COVID-19 patients were more male (p = 0.013), with a lower percentage of COPD (Chronic Obstructive Pulmonary Disease) and chronic kidney disease (CKD) (p = 0.001 and p = 0.037, respectively) than FLU. SOFA score was higher (p = 0.020) and lymphocytes were significantly lower in FLU than in COVID-19 [395.5 vs 770.0 cells/mmc, p = 0.005]. At multivariable analysis, male sex (OR 6.1, p < 0.002), age > 65 years (OR 2.4, p = 0.024) and lymphocyte count > 725 cells/mmc at ICU admission (OR 5.1, p = 0.024) were significantly associated with COVID-19, whereas CKD and COPD were associated with FLU (OR 0.1 and OR 0.16, p = 0.020 and p < 0.001, respectively). No differences in mortality, bacterial superinfections and thrombotic events were observed, whereas IPA was mostly associated with FLU (31.5% vs 3.6%, p = 0.0029).
Conclusions: In critically ill patients, male sex, age > 65 years and lymphocytes > 725 cells/mmc are related to COVID-19. FLU is associated with a significantly higher risk of IPA than COVID-19.
Keywords: COVID-19; Influenza; Intensive care unit; Invasive pulmonary aspergillosis; SARS-CoV-2; Superinfections; Thrombotic events.
. 2021 May 26.
doi: 10.1007/s15010-021-01624-7. Online ahead of print.
Comparison of clinical features and outcomes in COVID-19 and influenza pneumonia patients requiring intensive care unit admission
A Oliva[SUP] #[/SUP][SUP] 1 [/SUP], G Ceccarelli[SUP] #[/SUP][SUP] 2 [/SUP], C Borrazzo[SUP] 2 [/SUP], M Ridolfi[SUP] 2 [/SUP], G D 'Ettorre[SUP] 2 [/SUP], F Alessandri[SUP] 3 [/SUP], F Ruberto[SUP] 3 [/SUP], F Pugliese[SUP] 3 [/SUP], G M Raponi[SUP] 2 [/SUP], A Russo[SUP] 2 [/SUP], A Falletta[SUP] 2 [/SUP], C M Mastroianni[SUP] 2 [/SUP], M Venditti[SUP] 2 [/SUP]
Affiliations
- PMID: 34036458
- DOI: 10.1007/s15010-021-01624-7
Abstract
Background: Little is known in distinguishing clinical features and outcomes between coronavirus disease-19 (COVID-19) and influenza (FLU).
Materials/methods: Retrospective, single-centre study including patients with COVID-19 or FLU pneumonia admitted to the Intensive care Unit (ICU) of Policlinico Umberto I (Rome). Aims were: (1) to assess clinical features and differences of patients with COVID-19 and FLU, (2) to identify clinical and/or laboratory factors associated with FLU or COVID-19 and (3) to evaluate 30-day mortality, bacterial superinfections, thrombotic events and invasive pulmonary aspergillosis (IPA) in patients with FLU versus COVID-19.
Results: Overall, 74 patients were included (19, 25.7%, FLU and 55, 74.3%, COVID-19), median age 67 years (58-76). COVID-19 patients were more male (p = 0.013), with a lower percentage of COPD (Chronic Obstructive Pulmonary Disease) and chronic kidney disease (CKD) (p = 0.001 and p = 0.037, respectively) than FLU. SOFA score was higher (p = 0.020) and lymphocytes were significantly lower in FLU than in COVID-19 [395.5 vs 770.0 cells/mmc, p = 0.005]. At multivariable analysis, male sex (OR 6.1, p < 0.002), age > 65 years (OR 2.4, p = 0.024) and lymphocyte count > 725 cells/mmc at ICU admission (OR 5.1, p = 0.024) were significantly associated with COVID-19, whereas CKD and COPD were associated with FLU (OR 0.1 and OR 0.16, p = 0.020 and p < 0.001, respectively). No differences in mortality, bacterial superinfections and thrombotic events were observed, whereas IPA was mostly associated with FLU (31.5% vs 3.6%, p = 0.0029).
Conclusions: In critically ill patients, male sex, age > 65 years and lymphocytes > 725 cells/mmc are related to COVID-19. FLU is associated with a significantly higher risk of IPA than COVID-19.
Keywords: COVID-19; Influenza; Intensive care unit; Invasive pulmonary aspergillosis; SARS-CoV-2; Superinfections; Thrombotic events.