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Journal of Zhejiang University SCIENCE B 2021 Vol.22 No.2 P.87-98


Comparison of COVID-19 and influenza characteristics

Author(s):  Yu BAI, Xiaonan TAO

Affiliation(s):  Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China

Corresponding email(s):   taoxn2004@163.com

Key Words:  Coronavirus disease 2019 (COVID-19), Influenza, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

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Yu BAI, Xiaonan TAO. Comparison of COVID-19 and influenza characteristics[J]. Journal of Zhejiang University Science B, 2021, 22(2): 87-98.

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The emergence of coronavirus disease 2019 (COVID-19) not only poses a serious threat to the health of people worldwide but also affects the global economy. The outbreak of COVID-19 began in December 2019, at the same time as the influenza season. However, as the treatments and prognoses of COVID-19 and influenza are different, it is important to accurately differentiate these two different respiratory tract infections on the basis of their respective early-stage characteristics. We reviewed official documents and news released by the National Health Commission of the People's Republic of China, the Chinese Center for Disease Control and Prevention (China CDC), the United States CDC, and the World Health Organization (WHO), and we also searched the PubMed, Web of Science, Excerpta Medica database (Embase), China National Knowledge Infrastructure (CNKI), Wanfang, preprinted bioRxiv and medRxiv databases for documents and guidelines from earliest available date up until October 3rd, 2020. We obtained the latest information about COVID-19 and influenza and summarized and compared their biological characteristics, epidemiology, clinical manifestations, pathological mechanisms, treatments, and prognostic factors. We show that although COVID-19 and influenza are different in many ways, there are numerous similarities; thus, in addition to using nucleic acid-based polymerase chain reaction (PCR) and antibody-based approaches, clinicians and epidemiologists should distinguish between the two using their respective characteristics in early stages. We should utilize experiences from other epidemics to provide additional guidance for the treatment and prevention of COVID-19.


概要:由于新型冠状病毒型肺炎(COVID-19)和流感的治疗和预后不同,因此在使用核酸或抗体检测之前根据各自的早期特征准确区分这两种不同的呼吸道感染非常重要。为了帮助临床医生和流行病学家根据两种疾病各自的特点区分两者,我们作此综述。我们查阅了中华人民共和国国家卫生委员会、中国疾病预防控制中心、美国疾病控制中心和世界卫生组织发布的官方文件和新闻,并搜索了PubMed、Web of Science、Embase、知网、万方、预印本bioRxiv和medRxiv数据库,查找最早可用日期至2020年10月3日的文件和指南,获得了有关新冠肺炎和流感的最新信息,并对其生物学特征、流行病学、临床表现、病理机制、治疗和预后因素进行了总结和比较。虽然新冠肺炎和流感有很多不同之处,但也有很多相似之处,所以临床医生和流行病学家应该尽早区分它们,但在区分的同时也要注意两种疾病合并的可能。严重急性呼吸综合征冠状病毒2(SARS-CoV-2)和流感病毒都具有传染性高、发病率高、发病快、易变异的特点。SARS-CoV-2的传播率高于季节性流感,而季节性流感的死亡率远低于新冠肺炎。流感患者往往比新冠肺炎年轻,14岁以下的儿童相比新冠肺炎更容易患流感。与流感患者相比,新冠肺炎感染者更常见的是化学感觉障碍、皮疹的出现和生殖系统受损;新冠肺炎患者比流感患者更容易出现明显的全身性症状和干咳;流感患者发热相较于新冠肺炎患者更趋向于高热。影像表现方面,新冠肺炎患者磨玻璃样阴影多位于周边,累及下叶;流感患者阴影多呈中央型、外周型或随机型,纵隔气肿和气胸仅在流感研究中报道。病理上,流感患者的肺纤维化、血栓和出血比新冠肺炎患者更常见。流感患者的预后不良因素倾向于年轻和怀孕,但在新冠肺炎患者中这些都不是预后因素,而肥胖、具有其他合并症和老龄与死亡率的升高有关。


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