Differential diagnosis of coronavirus disease 2019 pneumonia or influenza A pneumonia by clinical characteristics and laboratory findings

• Main Authors: Chen, X.-Q (Author), Chu, J.-G (Author), He, Y.-W (Author), Liang, J. (Author), Lu, B.-B (Author), Lv, D.-F (Author), Mu, Q.-T (Author), Qian, G.-Q (Author), Weng, X.-B (Author), Ying, Q.-M (Author), Zhang, J.-H (Author)
• Format: Article
• Language: English
• Published: John Wiley and Sons Inc 2021
• Subjects: adult; age; albumin; albumin blood level; Article; aspartate aminotransferase; aspartate aminotransferase blood level; body temperature; C reactive protein; China; clinical characteristics; clinical feature; Clinical Laboratory Techniques; cohort analysis; coronavirus disease 2019; COVID-19; creatinine; creatinine blood level; Diagnosis, Differential; diagnostic imaging; diarrhea; differential diagnosis; early diagnosis; electronic medical record; erythrocyte count; fatigue; female; Female; ground glass opacity; hemoglobin; hemoglobin blood level; hospital admission; human; Humans; influenza A; Influenza A virus; laboratory diagnosis; laboratory technique; Logistic Models; lymphocyte count; lymphocyte percentage; major clinical study; male; Male; middle aged; Middle Aged; monocyte percentage; multivariate analysis; Multivariate Analysis; physiology; pleura effusion; pneumonia; Pneumonia; protein blood level; retrospective study; risk factor; Risk Factors; SARS-CoV-2; statistical model; Tomography, X-Ray Computed; virology; virus pneumonia; x-ray computed tomography
• Online Access: View Fulltext in Publisher

 Background: Pneumonia caused by the 2019 novel Coronavirus (COVID-2019) shares overlapping signs and symptoms, laboratory findings, imaging features with influenza A pneumonia. We aimed to identify their clinical characteristics to help early diagnosis. Methods: We retrospectively retrieved data for laboratory-confirmed patients admitted with COVID-19–induced or influenza A–induced pneumonia from electronic medical records in Ningbo First Hospital, China. We recorded patients' epidemiological and clinical features, as well as radiologic and laboratory findings. Results: The median age of influenza A cohort was higher and it exhibited higher temperature and higher proportion of pleural effusion. COVID-19 cohort exhibited higher proportions of fatigue, diarrhea and ground-glass opacity and higher levels of lymphocyte percentage, absolute lymphocyte count, red-cell count, hemoglobin and albumin and presented lower levels of monocytes, c-reactive protein, aspartate aminotransferase, alkaline phosphatase, serum creatinine. Multivariate logistic regression analyses showed that fatigue, ground-glass opacity, and higher level of albumin were independent risk factors for COVID-19 pneumonia, while older age, higher temperature, and higher level of monocyte count were independent risk factors for influenza A pneumonia. Conclusions: In terms of COVID-19 pneumonia and influenza A pneumonia, fatigue, ground-glass opacity, and higher level of albumin tend to be helpful for diagnosis of COVID-19 pneumonia, while older age, higher temperature, and higher level of monocyte count tend to be helpful for the diagnosis of influenza A pneumonia. © 2021 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC