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Comparison of Hospitalized Patients With ARDS Caused by COVID-19 and H1N1.
Tang, Xiao; Du, Rong-Hui; Wang, Rui; Cao, Tan-Ze; Guan, Lu-Lu; Yang, Cheng-Qing; Zhu, Qi; Hu, Ming; Li, Xu-Yan; Li, Ying; Liang, Li-Rong; Tong, Zhao-Hui; Sun, Bing; Peng, Peng; Shi, Huan-Zhong.
  • Tang X; Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing Engineering Research Center for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chao-Yang Hospital), Beijing Key
  • Du RH; Department of Respiratory and Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, China.
  • Wang R; Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing Engineering Research Center for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chao-Yang Hospital), Beijing Key
  • Cao TZ; Department of Respiratory and Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, China.
  • Guan LL; Department of Respiratory and Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, China.
  • Yang CQ; Department of Respiratory and Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, China.
  • Zhu Q; Department of Respiratory and Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, China.
  • Hu M; Department of Respiratory and Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, China.
  • Li XY; Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing Engineering Research Center for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chao-Yang Hospital), Beijing Key
  • Li Y; Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing Engineering Research Center for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chao-Yang Hospital), Beijing Key
  • Liang LR; Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing Engineering Research Center for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chao-Yang Hospital), Beijing Key
  • Tong ZH; Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing Engineering Research Center for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chao-Yang Hospital), Beijing Key
  • Sun B; Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing Engineering Research Center for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chao-Yang Hospital), Beijing Key
  • Peng P; Department of Respiratory and Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, China.
  • Shi HZ; Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing Institute of Respiratory Medicine, Beijing Engineering Research Center for Diagnosis and Treatment of Respiratory and Critical Care Medicine (Beijing Chao-Yang Hospital), Beijing Key
Chest ; 158(1): 195-205, 2020 07.
Article in English | MEDLINE | ID: covidwho-100891
ABSTRACT

BACKGROUND:

Since the outbreak of coronavirus disease 2019 (COVID-19) in China in December 2019, considerable attention has been focused on its elucidation. However, it is also important for clinicians and epidemiologists to differentiate COVID-19 from other respiratory infectious diseases such as influenza viruses. RESEARCH QUESTION The aim of this study was to explore the different clinical presentations between COVID-19 and influenza A (H1N1) pneumonia in patients with ARDS. STUDY DESIGN AND

METHODS:

This analysis was a retrospective case-control study. Two independent cohorts of patients with ARDS infected with either COVID-19 (n = 73) or H1N1 (n = 75) were compared. Their clinical manifestations, imaging characteristics, treatments, and prognosis were analyzed and compared.

RESULTS:

The median age of patients with COVID-19 was higher than that of patients with H1N1, and there was a higher proportion of male subjects among the H1N1 cohort (P < .05). Patients with COVID-19 exhibited higher proportions of nonproductive coughs, fatigue, and GI symptoms than those of patients with H1N1 (P < .05). Patients with H1N1 had higher Sequential Organ Failure Assessment (SOFA) scores than patients with COVID-19 (P < .05). The Pao2/Fio2 of 198.5 mm Hg in the COVID-19 cohort was significantly higher than the Pao2/Fio2 of 107.0 mm Hg in the H1N1 cohort (P < .001). Ground-glass opacities was more common in patients with COVID-19 than in patients with H1N1 (P < .001). There was a greater variety of antiviral therapies administered to COVID-19 patients than to H1N1 patients. The in-hospital mortality of patients with COVID-19 was 28.8%, whereas that of patients with H1N1 was 34.7% (P = .483). SOFA score-adjusted mortality of H1N1 patients was significantly higher than that of COVID-19 patients, with a rate ratio of 2.009 (95% CI, 1.563-2.583; P < .001).

INTERPRETATION:

There were many differences in clinical presentations between patients with ARDS infected with either COVID-19 or H1N1. Compared with H1N1 patients, patients with COVID-19-induced ARDS had lower severity of illness scores at presentation and lower SOFA score-adjusted mortality.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Hospital Mortality / Coronavirus Infections / Influenza, Human / Influenza A Virus, H1N1 Subtype / Pandemics / Symptom Assessment / Betacoronavirus Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Chest Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Hospital Mortality / Coronavirus Infections / Influenza, Human / Influenza A Virus, H1N1 Subtype / Pandemics / Symptom Assessment / Betacoronavirus Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Chest Year: 2020 Document Type: Article