Early distinctive clinical and hematological signs of hemorrhagic fever with renal syndrome and a new coronavirus infection occurring with lung damage

Abstract

Introduction. The study of the manifestations of symptoms of COVID-19 and hemorrhagic fever with renal syndrome (HFRS) is an important aspect of the diagnosis, especially for regions endemic for HFRS.Aim. To conduct сomparative study of the clinical symptoms and parametres of a complete blood test at the onset of the disease with lung involvement in patients with HFRS and COVID-19 with moderate severity.Materials and methods. A retrospective comparative analysis and identification of laboratory data of patients with moderate form of HFRS with respiratory syndrome (n = 52) and patients with moderate severity form of COVID-19 (n = 52) upon admission to the hospital was carried out.Results. Fever is one of the main symptoms for both diseases, characterizing the degree of severity. At the same time, the temperature in patients with HFRS on admission was higher than in patients with COVID-19 (p < 0.05). Shortness of breath is much more often recorded in the group of patients with viral pneumonia COVID-19 (p = 0.0001). The oxygen saturation index (SpO2) in patients with HFRS was below 95%, but the average value of 96.4% was normal, while in patients with COVID-19 the average value was 92.8% (p < 0.05). When comparing the indicators of the general blood test, there was a statistically significant excess of the level of red blood cells and hematocrit in the group of patients with COVID-19, with a comparable level of hemoglobin in both groups. The average value of the absolute content of platelets was significantly lower, and the number of patients with thrombocytopenia is much higher in the group of patients with HFRS.Conclusion. Kidney damage in HFRS is the main clinical and laboratory syndrome, but it is important to remember that lung damage by the type of viral pneumonia in HFRS is also possible. In all suspicious cases, an examination for SARS-CoV-2 and serological diagnosis of hantavirus infection are indicated.