Comparing clinical features of COVID-19 and seasonal influenza

The United States is still in the midst of the COVID-19 pandemic and the 2020-2021 influenza season is on the way. How much the upcoming season will tax a health care system that has been stretched is unknown. However, a new report in JAMA Network Open offers a look at the similarities and differences between COVID-19 and seasonal influenza.¹

The investigators ran a retrospective cohort study of children at the Children’s National Hospital in the District of Columbia. The children with influenza were diagnosed between October 1, 2019, and June 6, 2020. Children with laboratory-diagnosed COVID-19 were diagnosed between March 25, 2020, and May 15, 2020. The researchers looked at the rates of hospitalization, mechanical ventilator use, association between underlying medical conditions, and admission to the intensive care unit.

There were 315 children diagnosed with COVID-19 and 1402 children diagnosed with seasonal influenza in the study. The investigators found that both groups had similar hospitalization rates (54 [17%] vs 291 [21%], P = .15) and the use of mechanical ventilators (10 [3%] vs 27 [2%], P = .17), and intensive care unit admission rate (18 [6%] vs 98 [7%], P = .42).

Among patients who were hospitalized for either condition, more patients with COVID-19 than influenza were more likely to report the following symptoms:

• headache (6 [11%] vs 9 [3%], P = .01)
• body ache or myalgia (12 [22%] vs 20 [7%], P = .001)
• chest pain (6 [11%] vs 9 [3%], P = .01)
• reported fever (41 [76%] vs 159 [55%], P = .005)
• diarrhea or vomiting (14 [26%] vs 36 [12%], P = .01)

The researchers found that the difference between patients who were hospitalized for COVID-19 versus influenza and reported cough (24 [48%] vs 90 [31%], P = .05) and shortness of breath (16 [30%] vs 59 [20%], P = .13) was not statistically significant.

Investigators found no difference between children with COVID-19 and seasonal influenza for some key statistics including hospitalization rates, intensive care unit admission rates, and mechanical ventilator use. They also found that children who were hospitalized for COVID-19 were more likely to report clinical symptoms when they were diagnosed than children with seasonal influenza.

Reference

1. Song X, Delaney M, Shah R, Campos J, Wessel D, DeBiasi R. Comparison of clinical features of COVID-19 vs seasonal influenza A and B in US children. JAMA Netw Open. 2020;3(9):e2020495. doi:10.1001/jamanetworkopen.2020.20495