Comparison of Hospitalized Patients With ARDS Caused by COVID-19 and H1N1

被引：250

作者：

Tang, Xiao ^{[1
]}

Du, Rong-Hui ^{[2
]}

Wang, Rui ^{[1
]}

Cao, Tan-Ze ^{[2
]}

Guan, Lu-Lu ^{[2
]}

Yang, Cheng-Qing ^{[2
]}

Zhu, Qi ^{[2
]}

Hu, Ming ^{[2
]}

Li, Xu-Yan ^{[1
]}

Li, Ying ^{[1
]}

Liang, Li-Rong ^{[1
]}

Tong, Zhao-Hui ^{[1
]}

Sun, Bing ^{[1
]}

Peng, Peng ^{[2
]}

Shi, Huan-Zhong ^{[1
]}

机构：

[1] Capital Med Univ, Beijing Engn Res Ctr Diag & Treatment Resp & Crit, Beijing Key Lab Resp & Pulm Circulat Disorders, Beijing Chao Yang Hosp,Beijing Inst Resp Med,Dept, Beijing, Peoples R China

[2] Wuhan Pulm Hosp, Dept Resp & Crit Care Med, Wuhan, Peoples R China

来源：

CHEST | 2020年 / 158卷 / 01期

关键词：

ARDS; COVID-19; H1N1; influenza A; mortality; EXTRACORPOREAL MEMBRANE-OXYGENATION; RADIOLOGICAL FINDINGS; INFLUENZA; PNEUMONIA; INFECTION;

D O I：

10.1016/j.chest.2020.03.032

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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.

引用

页码：195 / 205

页数：11

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