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Updated: Jul 14, 2026
High-throughput Detection Method for Influenza Virus
Published on: February 4, 2012
Differentiating COVID-19 and influenza in children: hemogram parameters as diagnostic tools
Ramazan Dulkadir1, Bahar Oztelcan Gunduz2
1Ahi Evran University, Kırşehir, Türkiye.
Insights
Hematological parameters like eosinophil and monocyte counts can help differentiate COVID-19 from influenza in children. These easily accessible markers offer high sensitivity and specificity, aiding clinical diagnosis during outbreaks.
Area of Science:
- Pediatric infectious diseases
- Hematology
- Diagnostic markers
Background:
- Differentiating between influenza and COVID-19 based solely on symptoms in children is challenging.
- Accurate differential diagnosis is crucial for appropriate patient management and public health strategies.
Purpose of the Study:
- To investigate specific hematological parameters for distinguishing COVID-19 from influenza in pediatric patients.
- To identify reliable biomarkers for differential diagnosis in children presenting with similar respiratory symptoms.
Main Methods:
- A cohort of 231 children (1 month to 18 years) with influenza or COVID-19 were analyzed.
- Hematological parameters were evaluated, with a focus on eosinophil and monocyte counts.
- Receiver operating characteristic (ROC) curve analysis was used to assess diagnostic performance.
Main Results:
- Age, eosinophil count, and monocyte count were statistically significant factors in COVID-19 diagnosis.
- Monocyte count (AUC 0.990) and eosinophil count (AUC 0.989) demonstrated high diagnostic accuracy.
- High sensitivity and specificity were achieved for both monocyte (>1.50) and eosinophil (>0.02) counts.
Conclusions:
- Eosinophil and monocyte counts are valuable, accessible, and cost-effective parameters for differentiating COVID-19 from influenza in children.
- These hematological markers can aid clinicians in differential diagnosis, particularly during seasonal outbreaks.
- Implementing these parameters can streamline diagnostic workflows for pediatric respiratory infections.
Introduction:
It is not always possible to differentiate between influenza and COVID-19 based on symptoms alone. This is a topic of significant importance as it aims to determine whether there are specific hematological parameters that can be used to distinguish between influenza and COVID-19 in children.
Methodology:
Two hundred thirty-one children between the ages of 1 month and 18 years who presented to the children's outpatient clinic between June 2021 and June 2022 with similar symptoms and were tested with an influenza test and a COVID-19 PCR test were included in the study. Of the patients included in the study, 130 tested positive for COVID-19 and 101 positive for influenza. The patients were evaluated for hematological parameters.
Results:
Age, eosinophils and monocyte factors were shown to be statistically significantly effective in COVID-19. The risk of COVID-19 increased 1,484-fold with age, 10,708-fold with increasing eosinophil count, and 1,591-fold with increasing monocyte count. The performance of the monocyte count and eosinophil count was assessed by receiver operating characteristic curve (ROC) analysis. According to the performed ROC analysis, the area under the curve (AUC) value was observed to be 0.990 for monocytes. According to the cutoff point >1.50, the sensitivity value was determined as 98.4% and the specificity value as 97.0%. AUC significance for eosinophils was found to be 0.989. According to the cutoff point >0.02, the sensitivity value was determined as 99.2% and the specificity value as 93.1%.
Conclusion:
In the diagnosis of COVID-19, the eosinophil count and monocyte count are easily accessible, inexpensive, and important parameters in terms of differential diagnosis and can help in the differentiation of COVID-19 from influenza during seasonal outbreaks of the latter. Developing parameters for clinicians to use in diagnosing COVID-19 and influenza can facilitate their work in practice.
