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The comparison of COVID-19 vs seasonal influenza in children
Burcu Ceylan Cura Yayla1, Kubra Aykac1, Oguz Boluk2
1Department of Pediatric Infectious Diseases, Ankara Training and Research Hospital, University of Health Science, Ankara, Turkey.
Insights
Differentiating pediatric COVID-19 from influenza is possible using clinical factors. Age, fever, dyspnea, and C-reactive protein levels help distinguish between these respiratory illnesses in children.
Area of Science:
- Pediatric infectious diseases
- Respiratory viral infections
Background:
- Limited pediatric data exists for COVID-19 compared to influenza.
- Differentiating between COVID-19 and influenza is critical for pediatric patient management, especially during influenza season.
Purpose of the Study:
- To compare clinical characteristics and identify predictors for differentiating COVID-19 from influenza in pediatric patients.
- To aid clinicians in distinguishing between these two significant respiratory illnesses in children.
Main Methods:
- Retrospective study of pediatric patients diagnosed with laboratory-confirmed COVID-19 or seasonal influenza.
- Analysis included demographic data, underlying conditions, and clinical symptoms.
Main Results:
- 164 COVID-19 cases and 151 influenza cases were analyzed. COVID-19 patients were older (median 10 years) than influenza patients (median 4 years).
- Underlying diseases were more common in influenza patients (20.9%) than in COVID-19 patients (6.3%).
- Fever, dyspnea/tachypnea, and elevated C-reactive protein (CRP) were significant predictors of influenza. Lymphopenia was more prevalent in influenza patients (43.2%) compared to COVID-19 patients (19.9%).
Conclusions:
- Accurate differentiation between pediatric influenza and COVID-19 is feasible.
- A combination of factors including age, cough, fever, vomiting, leucopenia, lymphopenia, pneumonia, and high CRP levels can aid in distinguishing these illnesses.
Background:
Influenza in children has been well described, whereas there has been a paucity of pediatric data regarding COVID-19. It is crucial for clinicians to differentiate cases of COVID-19 from cases of influenza because of the upcoming influenza season in the new pandemic era.
Methods:
This retrospective study included pediatric patients who were diagnosed with laboratory-confirmed COVID-19 between March and September 2020, or seasonal influenza between October 2019 and March 2020.
Results:
A total of 315 children were included in this study; 151 were diagnosed with influenza and 164 had confirmed COVID-19. The median age of patients with COVID-19 was 10 years (interquartile range [IQR]: 3-15 years), whereas the median age of patients with influenza was 4 years (IQR: 1-6 years) (p = 0.001). In the COVID-19 group, 6.3% of patients had underlying diseases, the most frequent being neurological conditions (3%). In the influenza group, 20.9% of patients had an underlying disease, the most frequent being asthma (14.5%). Fever (odds ratio [OR]: 20.476; 95% confidence interval [CI]: 2.438-171.995; p = 0.005), dyspnea/tachypnea (OR 13.950; 95% CI: 2.607-74.634; p = 0.002), and increased C-reactive protein (CRP) (OR: 7.650; 95% CI: 2.094-27.955; p = 0.002) were main predictors of influenza diagnosis in comparison to COVID-19. Lymphopenia was detected in 43.2% of patients with influenza and 19.9% of patients with COVID-19 (p = 0.001).
Conclusions:
The accurate differentiation between "influenza or COVID-19" seems possible by evaluating a combination of factors including cough, fever, vomiting, leucopenia, lymphopenia, pneumonia, in pediatric patients with high CRP as well as age.
