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

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Summary

Introduction

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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