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Updated: May 29, 2025

Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
Differences of the Chest Images Between Coronavirus Disease 2019 (COVID-19) Patients and Influenza Patients: A
Yingying Han1, Zhijia Wang2, Xingzhao Li3
1Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China, 130000, ORCID: 0000-0002-3583-0448.
Insights
Chest imaging reveals distinct patterns for COVID-19 versus influenza. COVID-19 patients show more peripheral lesions and ground-glass opacities, while pleural effusion is less common.
Area of Science:
- Radiology
- Infectious Diseases
- Pulmonology
Background:
- Coronavirus disease 2019 (COVID-19) and influenza are significant global health threats.
- Distinguishing between these viral respiratory illnesses is crucial for effective patient management.
Purpose of the Study:
- To compare chest imaging findings between COVID-19 and influenza patients.
- To enhance understanding of the radiological differences between these two diseases.
Main Methods:
- A systematic literature search was conducted on PubMed, Embase, and Web of Science.
- A meta-analysis of 26 studies involving 2,159 COVID-19 and 1,568 influenza patients was performed.
- Chest computed tomography (CT) and X-ray findings were analyzed.
Main Results:
- COVID-19 patients exhibited more peripheral lung lesions, ground-glass opacities, reverse halo signs, interlobular septal thickening, vascular enlargement, and crazy-paving patterns.
- Pleural effusion was significantly less common in COVID-19 patients compared to influenza patients.
- While trends suggested more bilateral and less unilateral lung involvement in COVID-19, these findings lacked statistical significance.
Conclusions:
- Distinct differences exist in chest imaging manifestations between COVID-19 and influenza.
- These radiological distinctions can aid in differentiating between the two infectious diseases.
Abstract:
Background: Coronavirus disease 2019 (COVID-19) and influenza are two infectious diseases that can pose a great threat to human health. We aimed to compare the differences in chest images between patients with COVID-19 and influenza to deepen the understanding of these two diseases. Methods: We searched PubMed, Embase and Web of Science for articles published before December 25, 2023, and performed a meta-analysis using Stata 14.0 with a random-effects model. The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Twenty-six articles with 2,159 COVID-19 patients and 1,568 influenza patients were included in the meta-analysis. By comparing chest computed tomography (CT) and chest X-ray, we found that COVID-19 patients had more peripheral lung lesions (OR=3.66, 95% CI: 1.84-7.31). Although COVID-19 patients had more bilateral lung involvement (OR=1.74, 95% CI: 0.90-3.38) and less unilateral lung involvement (OR=0.67, 95% CI: 0.44-1.02), these two results were not statistically significant. Patients with COVID-19 showed more ground-glass opacities (OR=2.83, 95% CI: 1.85-4.32), reverse halo signs (OR=3.47, 95% CI: 2.37-5.08), interlobular septal thickening (OR=2.16, 95% CI: 1.55-3.01), vascular enlargement (OR=5.00, 95% CI: 1.80-13.85) and crazy-paving patterns (OR=2.63, 95% CI: 1.57-4.41) on chest images than patients with influenza. We also found that compared with influenza patients, pleural effusion was rare in COVID-19 patients (OR=0.15, 95% CI: 0.07-0.31). Conclusions: There are some differences in the manifestations and distributions of lesions between patients with COVID-19 and influenza on chest images, which is helpful to distinguish these two infectious diseases.
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