Abstract
There is a need for a quick assessment of severely ill patients presenting to the hospital. The objectives of this study were to identify clinical, laboratory and imaging parameters that could differentiate between influenza and COVID-19 and to assess the frequency and impact of early bacterial co-infection. A prospective observational cohort study was performed between February 2019 and April 2020. A retrospective cohort was studied early in the COVID-19 pandemic. Patients suspected of sepsis with PCR-confirmed influenza or SARS-CoV-2 were included. A multivariable logistic regression model was built to differentiate COVID-19 from influenza. In total, 103 patients tested positive for influenza and 110 patients for SARS-CoV-2, respectively. Hypertension (OR 6.550), both unilateral (OR 4.764) and bilateral (OR 7.916), chest X-ray abnormalities, lower temperature (OR 0.535), lower absolute leukocyte count (OR 0.857), lower AST levels (OR 0.946), higher LDH (OR 1.008), higher ALT (OR 1.044) and higher ferritin (OR 1.001) were predictive of COVID-19. Early bacterial co-infection was more frequent in patients with influenza (10.7% vs. 2.7%). Empiric antibiotic usage was high (76.7% vs. 84.5%). Several factors determined at presentation to the hospital can differentiate between influenza and COVID-19. In the future, this could help in triage, diagnosis and early management. Clinicaltrial.gov Identifier: NCT03841162
Highlights
Seasonal influenza, caused by the influenza virus, causes 4–50 million symptomatic cases in EU/EEA and approximately 500,000 cases in Belgium per year [1, 2]
From the 12th of March 2020 until the 12th of April, 110 patients admitted with suspected sepsis were PCR confirmed with SARS-CoV-2
This study shows the clinical, laboratory and imaging differences between patients with influenza and patients with
Summary
Seasonal influenza, caused by the influenza virus, causes 4–50 million symptomatic cases in EU/EEA and approximately 500,000 cases in Belgium per year [1, 2]. Influenza season is almost exclusively limited to the winter months: from November until April in the Northern. The coronavirus disease 2019 (COVID-19) pandemic, caused by the novel coronavirus SARS-CoV-2, resulted in 9,063,320 confirmed cases in the EU/EEA until 8th November 2020. In Belgium, the first case was reported on the 2nd of March 2020 [3, 4]. On the 9th of November 2020, 500,789 cases were confirmed in Belgium, with 13,055 reported COVID-19-related deaths [4]. Patients with COVID-19 can rapidly deteriorate shortly after admission, and close monitoring is needed [5, 6]
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