Distinguishing between COVID-19 and influenza during the early stages by measurement of peripheral blood parameters

J Med Virol. 2021 Feb;93(2):1029-1037. doi: 10.1002/jmv.26384. Epub 2020 Aug 13.

Abstract

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 infection. This study aims to examine the changes in peripheral blood parameters during the early stages of COVID-19 and influenza. We analyzed the peripheral blood parameters of 169 COVID-19 patients and 131 influenza patients during the early-onset stage. Results from the patients with COVID-19 were compared with those from healthy controls and influenza patients. In addition, results from patients with common and severe COVID-19 were further compared. There were significant differences between COVID-19 and influenza patients in terms of age, white blood cell count, platelet count, percentage of neutrophils, percentage of lymphocytes, percentage of monocytes, percentage of eosinophils, percentage of basophils, neutrophil, count and monocyte count. Two parameters (monocyte count and percentage of basophils) were combined to clarify the diagnostic efficacy of COVID-19 and influenza and the area under the curve was found to be 0.772. Comparison of peripheral blood parameters from common COVID-19, severe COVID-19, and influenza patients revealed many differences during the early disease stages. The diagnostic formula developed by this study will be of benefit for physicians in the differentiation of COVID-19 and influenza.

Keywords: COVID-19; SARS-CoV-2; biochemical parameters; blood routine parameters; influenza.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19 / blood*
  • COVID-19 / diagnosis*
  • China
  • Diagnosis, Differential
  • Female
  • Humans
  • Influenza, Human / blood*
  • Influenza, Human / diagnosis*
  • Leukocyte Count
  • Lymphocytes / cytology
  • Male
  • Middle Aged
  • Monocytes / cytology
  • Neutrophils / cytology
  • Platelet Count
  • Young Adult