Abstract
BackgroundThere is an urgent need to better understand the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), for that the coronavirus disease 2019 (COVID-19) continues to cause considerable morbidity and mortality worldwide. This paper was to differentiate COVID-19 from other respiratory infectious diseases such as avian-origin influenza A (H7N9) and influenza A (H1N1) virus infections.MethodsWe included patients who had been hospitalized with laboratory-confirmed infection by SARS-CoV-2 (n = 83), H7N9 (n = 36), H1N1 (n = 44) viruses. Clinical presentation, chest CT features, and progression of patients were compared. We used the Logistic regression model to explore the possible risk factors.ResultsBoth COVID-19 and H7N9 patients had a longer duration of hospitalization than H1N1 patients (P < 0.01), a higher complication rate, and more severe cases than H1N1 patients. H7N9 patients had higher hospitalization-fatality ratio than COVID-19 patients (P = 0.01). H7N9 patients had similar patterns of lymphopenia, neutrophilia, elevated alanine aminotransferase, C-reactive protein, lactate dehydrogenase, and those seen in H1N1 patients, which were all significantly different from patients with COVID-19 (P < 0.01). Either H7N9 or H1N1 patients had more obvious symptoms, like fever, fatigue, yellow sputum, and myalgia than COVID-19 patients (P < 0.01). The mean duration of viral shedding was 9.5 days for SARS-CoV-2 vs 9.9 days for H7N9 (P = 0.78). For severe cases, the meantime from illness onset to severity was 8.0 days for COVID-19 vs 5.2 days for H7N9 (P < 0.01), the comorbidity of chronic heart disease was more common in the COVID-19 patients than H7N9 (P = 0.02). Multivariate analysis showed that chronic heart disease was a possible risk factor (OR > 1) for COVID-19, compared with H1N1 and H7N9.ConclusionsThe proportion of severe cases were higher for H7N9 and SARS-CoV-2 infections, compared with H1N1. The meantime from illness onset to severity was shorter for H7N9. Chronic heart disease was a possible risk factor for COVID-19.The comparison may provide the rationale for strategies of isolation and treatment of infected patients in the future.
Highlights
There is an urgent need to better understand the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), for that the coronavirus disease 2019 (COVID-19) continues to cause considerable mor‐ bidity and mortality worldwide
Subjects hospitalized with H7N9: avian-origin influenza A (H7N9) and H1N1: influenza A (H1N1) had the highest prevalence of hypertension and smoking
Before we collect the data, all the patients hospitalized with COVID-19 were discharged from hospital except for one death. Both COVID-19 and H7N9 patients had a longer duration of hospitalization than H1N1 patients (P < 0.01) (Fig. 1), a higher complication rate, and more severe cases than H1N1 patients
Summary
There is an urgent need to better understand the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), for that the coronavirus disease 2019 (COVID-19) continues to cause considerable mor‐ bidity and mortality worldwide. This paper was to differentiate COVID-19 from other respiratory infectious diseases such as avian-origin influenza A (H7N9) and influenza A (H1N1) virus infections. The emergence of human infections with the SARSCoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) virus and its rapid national and international spread poses a global health emergency [1]. The pattern of transmission and the characteristics of the disease are similar to influenza initially, they are from different viral families [4]. It may confuse in identifying influenza and COVID-19 (the Coronavirus disease 2019) for that common symptoms include fever and cough, whereas gastrointestinal symptoms (eg, nausea, vomiting, diarrhea) [4]. Two highly pathogenic influenza virus, the avian influenza A (H7N9) and influenza A/H1N1/2009 virus have emerged in two separate events
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