Comparative study of hospitalized children with acute respiratory distress syndrome caused by SARS-CoV-2 and influenza virus

BMC Infect Dis. 2021 May 4;21(1):412. doi: 10.1186/s12879-021-06068-w.

Abstract

Background: Since the outbreak of coronavirus disease 2019 in December 2019, more than 8 million cases have occurred worldwide as of June 16, 2020. However, it is important to distinguish COVID-19 from other respiratory infectious diseases, such as influenza. Here, we comparatively described the clinical characteristics of children with COVID-19 and paediatric patients with influenza.

Methods: In this retrospective, single-centre study, we reviewed the electronic medical records of 585 paediatric patients with COVID-19 or influenza in Wuhan Children's Hospital, China. Clinical and epidemiological characteristics, laboratory findings, and clinical outcomes were comparatively analysed.

Results: The median ages were 6.96 years (IQR, 2-10.81) for children with confirmed COVID-19, 2.67 years (IQR, 1.03-15.25) for those with influenza A and 3.67 years (IQR, 1.62-5.54) for those with influenza B. Fever was a symptom in 84 (34.7%) COVID-19 cases, 132 (70.21%) influenza A cases and 111 (74.50%) influenza B cases. The median length of stay (LOS) was 11 (8-15) days for paediatric COVID-19 patients, 4 (3-6) days for influenza A patients and 5 (3-6) days for influenza B patients. Twenty-six (13.98%) influenza A patients and 18 (12.59%) influenza B patients presented with decreased white blood cell counts, while 13 (5.33%) COVID-19 patients presented with decreased white blood cell counts. Eight (3.28%) COVID-19 patients, 23 (12.71%) influenza A patients and 21 (14.79%) influenza B patients experienced lymphocytopenia. Acute cardiac injury occurred in 18 (7.29%) COVID-19 patients, while 37 (19.68%) influenza A and 27 (18.12%) influenza B patients had acute cardiac injury.

Conclusion: In this study, the illnesses of children with COVID-19 were demonstrated to be less severe than those of paediatric patients with influenza, and COVID-19 patients had milder illness and fewer complications.

Keywords: COVID-19; Children; Clinical features; Influenza; SARS-CoV-2.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • COVID-19 / epidemiology
  • COVID-19 / etiology*
  • COVID-19 Drug Treatment*
  • Child
  • Child, Hospitalized
  • Child, Preschool
  • China / epidemiology
  • Comorbidity
  • Female
  • Fever / epidemiology
  • Hospitals, Pediatric
  • Humans
  • Infant
  • Influenza, Human / drug therapy*
  • Influenza, Human / epidemiology
  • Influenza, Human / etiology*
  • Length of Stay
  • Lymphopenia / epidemiology
  • Lymphopenia / virology
  • Male
  • Respiratory Distress Syndrome / drug therapy
  • Respiratory Distress Syndrome / epidemiology
  • Respiratory Distress Syndrome / etiology
  • Respiratory Distress Syndrome / virology
  • Retrospective Studies