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Similarities and Differences Between SARS-Cov-2 and Influenza Infection from Symptom to Diagnosis in Childhood

Year 2023, , 211 - 216, 24.10.2023
https://doi.org/10.26650/jchild.2023.1059843

Abstract

Objective: The COVID-19 pandemic and annual influenza epidemic are responsible for thousands of deaths globally. This study was conducted to identify epidemiological aspects while demonstrating features that distinguish between influenza infection and COVID-19 disease in terms of clinical manifestations, laboratory, and prevention.
Methods: The patients hospitalized with confirmed influenza between October 2009-May 2014 (n=344) and with confirmed COVID-19 between April 2020-June 2021 (n=251) were enrolled in this study.
Results: The age of the patients with influenza infection was statistically significantly younger than the patients with SARS-CoV-2 infection (mean age 6 ± 5.3 years versus 13.0 ± 5.3 years, p <0.001). Fever, cough, and myalgia were the more common symptoms of influenza (p< 0.001; p<0.001, p=0.02). It was found that in cases of COVID-19 (n=55/251, 21.9%), headache complaints were more common at admission. Lymphopenia (n=89/251 35.4%) in COVID-19 and CRP elevation detected in influenza cases (n=201/344 58.4%) were statistically significant (p=0.01/ p<0.001). The mean hospital stay was 6±5 days (1-90 days) in influenza and 1±4 (1-64 days) in COVID-19 (p< 0.001). The radiological investigations were less necessary in children with COVID19 because of the lower overall incidence of infected, symptomatic, and severe cases and the lower presence of cough and respiratory symptoms compared to adults.
Conclusions: As the clinical and epidemiological features of COVID-19 have many parallels with influenza, it is important to ensure optimal management of both respiratory diseases as we expect that co-circulation will continue. Clinical findings in children are not sufficient for a definitive diagnosis, so it should be supported by a viral diagnosis test.

References

  • Bedford J., Farrar J., Ihekweazu C., Kang G., Koopmans M. al. J. A new twenty-first century science for effective epidemic response. Nature. 2019;575(7):130-136. doi: 10.1038/s41586-019-1717-y google scholar
  • Dawood F.S., Jain S., Finelli L., Shaw M.W., Lindstrom S. Et al. Emergence of a novel swine-origin influenza a (H1N1) virus in humans. N Engl J Med. 2009;360(25):2605-2615. doi: 10.1056/ NEJMoa0903810 google scholar
  • Somes MP, Turner RM, Dwyer LJ, Newall AT. Estimating the annual attack rate of seasonal influenza among unvaccinated individuals: A systematic review and meta-analysis. Vaccine. 2018; 31;36(23):3199-3207. doi: 10.1016/j.vaccine.2018.04.063 google scholar
  • Nicholson KG, McNally T, Silverman M, Stockton J, Zambon M. Rates of hospitalisation for influenza, respiratory syncytial virus and human metapneumovirus among infants and young children. Vaccine 2006; 24: 102-108. doi: 10.1016/j.vaccine.2005.02.004 google scholar
  • Karbuz A, Akkoc G, Bedir Demirdag T, Yilmaz Ciftdogan D, Ozer A, Cakir D, et al. Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey. Front Pediatr. 2021 May 7;9:631547. doi: 10.3389/fped.2021.631547 google scholar Dong Y, Mo X, HuY, Qi X, Jiang F, Jiang Z, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics 2020; 145 (6) e20200702 doi: 10.1542/ peds.2020-0702 google scholar
  • CDC COVID-19 Response Team, Coronavirus Disease 2019 in Children — United States, February 12-April 2, 2020, Morbidity and Mortality Weekly Report Weekly 2020;69(14);422-6 doi: 10.15585/mmwr.mm6914e4 google scholar
  • The American Academy of Pediatrics Children and COVID-19: State Data Report— United States, Version: 9/9/21, Available on: https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/ (Accessed date: 14.09.2021) google scholar
  • Brodin P. Why is COVID-19 so mild in children? ActaPaediatr. 2020 Jun;109(6):1082-1083. doi: 10.1542/peds.113.6.1758 google scholar
  • lwane MK, Edwards KM, Szilagyi PG, et al. Population-based surveillance for hospitalizations associated with respiratory syncytial virus, influenza virus, and parainfluenza viruses among young children. Pediatrics 2004; 113: 1758-1764 doi: 10.1542/ peds.113.6.1758. google scholar
  • Alsohime F, Temsah MH, Al-Nemri AM, Somily AM, Al-Subaie S. COVID-19 infection prevalence in pediatric population: Etiology, clinical presentation, and outcome. J Infect Public Health. 2020 Dec;13(12):1791-1796. doi: 10.1016/j.jiph.2020.10.008 google scholar
  • Nuezil KM, Mellen BG, Wright PF, Mitchel E, Griffin M. The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med 2000; 342: 225-231 doi: 10.1056/NEJM200001273420401 google scholar
  • Szenborn L, Toczek-Kubicka K, Zaryczanski J, Marchewka-Kowalik M, Miskiewicz K, Kuchar E. Benign Acute Childhood Myositis During Influenza B Outbreak. Adv Exp Med Biol. 2018;1039:29-34. doi: 10.1007/5584_2017_79 google scholar
  • Hoang A, Chorath K, Moreira A, Evans M, Burmeister-Morton F, Burmeister F, et al. COVID-19 in 7780 pediatric patients: a systematic review. EClinicalMedicine. 2020; 24:100433. doi: 10.1016/j.eclinm.2020.100433 google scholar
  • Ding Y, Yan H, Guo W. Clinical characteristics of children with COVID-19: a meta-analysis. Front Pediatr. 2020; 8:431. doi: 10.3389/fped.2020.00431 google scholar
  • Foust A.M., Winant A.J., Chu W.C. Pediatric SARS, H1N1, MERS, EVALI, and now Coronavirus Disease (COVID-19) pneumonia: what radiologists need to know. AJR Am J Roentgenol. 2020;1-9. doi: 10.2214/AJR.20.23267 google scholar
  • Ma H., Hu J., Tian J. A single-center, retrospective study of COVID-19 features in children: a descriptive investigation. BMC Med. 2020;18(1):123.doi: 10.1186/s12916-020-01596-9 google scholar
  • Ruuskanen O, Lahti E, Jennings LC, Murdoch DR. Viral pneumonia. Lancet. 2011; Apr 9;377(9773):1264-75. doi: 10.1016/S0140-6736(10)61459-6 google scholar
  • T. Valente, F. Lassandro, M. Marino, F. Squillante, M. Aliperta et al. “H1N1 pneumonia: our experience in 50 patients with a severe clinical course of novel swine-origin influenza A (H1N1) virus (S-OIV),” La Radiologia Medica. 2021; 117(2):165-184. doi: 10.1007/s11547-011-0734-1 google scholar

Çocuklarda SARS-Cov-2 ve İnfluenza Enfeksiyonunda Semptomdan Tanıya Benzerlikler ve Farklılıklar

Year 2023, , 211 - 216, 24.10.2023
https://doi.org/10.26650/jchild.2023.1059843

Abstract

Amaç: Bu çalışmada, çocuklarda klinik bulgular, laboratuvar tanısı ve hastalığı önleme açısından influenza enfeksiyonu ve COVID-19 hastalığı arasında ayrım yapan özellikleri gösterirken epidemiyolojik verileri de gözden geçirmek ve sentezlemek amaçlanmıştır.
Yöntem: Bu çalışmaya Ekim 2009-Mayıs 2014 yılları arasında hastanede yatan doğrulanmış influenza enfeksiyonu olan (n: 344) ve Nisan 2020-Haziran 2021 tarihleri arasında doğrulanmış COVID-19 (n: 251) nedeniyle yatan hastalar dahil edilmiştir.
Bulgular: İnfluenza enfeksiyonu olanlarda yaş, SARS-CoV-2 enfeksiyonuna göre istatistiksel olarak anlamlı küçük saptandı (ort. yaş 6 ± 5.3/13.0 ± 5.3, p <0.001). Ateş, öksürük ve miyalji influenzada en sık semptomlardı (p<0.001; p<0.001, p=0.02). Baş ağrısı hastaneye başvuruda COVID-19 olgularında daha sık bulundu (n=55/251, 21.9%). COVID-19 da lenfopeni, influenza olgularında ise CRP yüksekliği istatistiksel olarak yüksek bulundu(p=0.01/p<0.001). Ortalama hastanede kalış süresi influenzada 6±5 gün (1-90), COVID-19’da 1±4 gün (1-64) bulundu (p<0.001). Erişkinlere kıyasla öksürük ve solunum şikayetlerinin daha az olması, semptomatik ve ciddi vakaların da daha az olması sebebiyle radyolojik görüntülemelere COVID-19 hastalarında daha az ihtiyaç duyulmuştur.
Sonuç: COVID-19’un klinik ve epidemiyolojik bulguları influenza ile paralellik göstermekle birlikte, her iki etkenin de dolaşımda devam edeceği düşünülürse her iki hastalığında optimal yönetimini sağlamak önemlidir. Ani başlayan ateş, öksürük, miyalji gibi bulgular influenza açısından uyarıcı olsa da tanı için yeterli olmadığından viral tanı testlerinin kullanımı önemlidir.

References

  • Bedford J., Farrar J., Ihekweazu C., Kang G., Koopmans M. al. J. A new twenty-first century science for effective epidemic response. Nature. 2019;575(7):130-136. doi: 10.1038/s41586-019-1717-y google scholar
  • Dawood F.S., Jain S., Finelli L., Shaw M.W., Lindstrom S. Et al. Emergence of a novel swine-origin influenza a (H1N1) virus in humans. N Engl J Med. 2009;360(25):2605-2615. doi: 10.1056/ NEJMoa0903810 google scholar
  • Somes MP, Turner RM, Dwyer LJ, Newall AT. Estimating the annual attack rate of seasonal influenza among unvaccinated individuals: A systematic review and meta-analysis. Vaccine. 2018; 31;36(23):3199-3207. doi: 10.1016/j.vaccine.2018.04.063 google scholar
  • Nicholson KG, McNally T, Silverman M, Stockton J, Zambon M. Rates of hospitalisation for influenza, respiratory syncytial virus and human metapneumovirus among infants and young children. Vaccine 2006; 24: 102-108. doi: 10.1016/j.vaccine.2005.02.004 google scholar
  • Karbuz A, Akkoc G, Bedir Demirdag T, Yilmaz Ciftdogan D, Ozer A, Cakir D, et al. Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey. Front Pediatr. 2021 May 7;9:631547. doi: 10.3389/fped.2021.631547 google scholar Dong Y, Mo X, HuY, Qi X, Jiang F, Jiang Z, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics 2020; 145 (6) e20200702 doi: 10.1542/ peds.2020-0702 google scholar
  • CDC COVID-19 Response Team, Coronavirus Disease 2019 in Children — United States, February 12-April 2, 2020, Morbidity and Mortality Weekly Report Weekly 2020;69(14);422-6 doi: 10.15585/mmwr.mm6914e4 google scholar
  • The American Academy of Pediatrics Children and COVID-19: State Data Report— United States, Version: 9/9/21, Available on: https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/ (Accessed date: 14.09.2021) google scholar
  • Brodin P. Why is COVID-19 so mild in children? ActaPaediatr. 2020 Jun;109(6):1082-1083. doi: 10.1542/peds.113.6.1758 google scholar
  • lwane MK, Edwards KM, Szilagyi PG, et al. Population-based surveillance for hospitalizations associated with respiratory syncytial virus, influenza virus, and parainfluenza viruses among young children. Pediatrics 2004; 113: 1758-1764 doi: 10.1542/ peds.113.6.1758. google scholar
  • Alsohime F, Temsah MH, Al-Nemri AM, Somily AM, Al-Subaie S. COVID-19 infection prevalence in pediatric population: Etiology, clinical presentation, and outcome. J Infect Public Health. 2020 Dec;13(12):1791-1796. doi: 10.1016/j.jiph.2020.10.008 google scholar
  • Nuezil KM, Mellen BG, Wright PF, Mitchel E, Griffin M. The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med 2000; 342: 225-231 doi: 10.1056/NEJM200001273420401 google scholar
  • Szenborn L, Toczek-Kubicka K, Zaryczanski J, Marchewka-Kowalik M, Miskiewicz K, Kuchar E. Benign Acute Childhood Myositis During Influenza B Outbreak. Adv Exp Med Biol. 2018;1039:29-34. doi: 10.1007/5584_2017_79 google scholar
  • Hoang A, Chorath K, Moreira A, Evans M, Burmeister-Morton F, Burmeister F, et al. COVID-19 in 7780 pediatric patients: a systematic review. EClinicalMedicine. 2020; 24:100433. doi: 10.1016/j.eclinm.2020.100433 google scholar
  • Ding Y, Yan H, Guo W. Clinical characteristics of children with COVID-19: a meta-analysis. Front Pediatr. 2020; 8:431. doi: 10.3389/fped.2020.00431 google scholar
  • Foust A.M., Winant A.J., Chu W.C. Pediatric SARS, H1N1, MERS, EVALI, and now Coronavirus Disease (COVID-19) pneumonia: what radiologists need to know. AJR Am J Roentgenol. 2020;1-9. doi: 10.2214/AJR.20.23267 google scholar
  • Ma H., Hu J., Tian J. A single-center, retrospective study of COVID-19 features in children: a descriptive investigation. BMC Med. 2020;18(1):123.doi: 10.1186/s12916-020-01596-9 google scholar
  • Ruuskanen O, Lahti E, Jennings LC, Murdoch DR. Viral pneumonia. Lancet. 2011; Apr 9;377(9773):1264-75. doi: 10.1016/S0140-6736(10)61459-6 google scholar
  • T. Valente, F. Lassandro, M. Marino, F. Squillante, M. Aliperta et al. “H1N1 pneumonia: our experience in 50 patients with a severe clinical course of novel swine-origin influenza A (H1N1) virus (S-OIV),” La Radiologia Medica. 2021; 117(2):165-184. doi: 10.1007/s11547-011-0734-1 google scholar
There are 18 citations in total.

Details

Primary Language English
Subjects Paediatrics
Journal Section Research Articles
Authors

Asuman Demirbuğa 0000-0001-8928-1555

Selda Hançerli Törün This is me 0000-0002-3216-2413

Özge Kaba 0000-0002-8381-3255

Süheyla Gümüş This is me 0000-0002-7324-3922

Raif Yıldız 0000-0003-1636-1241

Metin Uysalol 0000-0002-4955-8182

Sevim Meşe 0000-0001-5944-0180

Mustafa Önel 0000-0002-3987-6611

Ali Ağaçfidan 0000-0002-5470-296X

Ayper Somer 0000-0002-7827-1113

Publication Date October 24, 2023
Published in Issue Year 2023

Cite

APA Demirbuğa, A., Törün, S. H., Kaba, Ö., Gümüş, S., et al. (2023). Similarities and Differences Between SARS-Cov-2 and Influenza Infection from Symptom to Diagnosis in Childhood. Çocuk Dergisi, 23(3), 211-216. https://doi.org/10.26650/jchild.2023.1059843
AMA Demirbuğa A, Törün SH, Kaba Ö, Gümüş S, Yıldız R, Uysalol M, Meşe S, Önel M, Ağaçfidan A, Somer A. Similarities and Differences Between SARS-Cov-2 and Influenza Infection from Symptom to Diagnosis in Childhood. Çocuk Dergisi. October 2023;23(3):211-216. doi:10.26650/jchild.2023.1059843
Chicago Demirbuğa, Asuman, Selda Hançerli Törün, Özge Kaba, Süheyla Gümüş, Raif Yıldız, Metin Uysalol, Sevim Meşe, Mustafa Önel, Ali Ağaçfidan, and Ayper Somer. “Similarities and Differences Between SARS-Cov-2 and Influenza Infection from Symptom to Diagnosis in Childhood”. Çocuk Dergisi 23, no. 3 (October 2023): 211-16. https://doi.org/10.26650/jchild.2023.1059843.
EndNote Demirbuğa A, Törün SH, Kaba Ö, Gümüş S, Yıldız R, Uysalol M, Meşe S, Önel M, Ağaçfidan A, Somer A (October 1, 2023) Similarities and Differences Between SARS-Cov-2 and Influenza Infection from Symptom to Diagnosis in Childhood. Çocuk Dergisi 23 3 211–216.
IEEE A. Demirbuğa, “Similarities and Differences Between SARS-Cov-2 and Influenza Infection from Symptom to Diagnosis in Childhood”, Çocuk Dergisi, vol. 23, no. 3, pp. 211–216, 2023, doi: 10.26650/jchild.2023.1059843.
ISNAD Demirbuğa, Asuman et al. “Similarities and Differences Between SARS-Cov-2 and Influenza Infection from Symptom to Diagnosis in Childhood”. Çocuk Dergisi 23/3 (October 2023), 211-216. https://doi.org/10.26650/jchild.2023.1059843.
JAMA Demirbuğa A, Törün SH, Kaba Ö, Gümüş S, Yıldız R, Uysalol M, Meşe S, Önel M, Ağaçfidan A, Somer A. Similarities and Differences Between SARS-Cov-2 and Influenza Infection from Symptom to Diagnosis in Childhood. Çocuk Dergisi. 2023;23:211–216.
MLA Demirbuğa, Asuman et al. “Similarities and Differences Between SARS-Cov-2 and Influenza Infection from Symptom to Diagnosis in Childhood”. Çocuk Dergisi, vol. 23, no. 3, 2023, pp. 211-6, doi:10.26650/jchild.2023.1059843.
Vancouver Demirbuğa A, Törün SH, Kaba Ö, Gümüş S, Yıldız R, Uysalol M, Meşe S, Önel M, Ağaçfidan A, Somer A. Similarities and Differences Between SARS-Cov-2 and Influenza Infection from Symptom to Diagnosis in Childhood. Çocuk Dergisi. 2023;23(3):211-6.