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

• Published in: Journal of Clinical Laboratory Analysis Vol. 35; no. 2; pp. e23685 - n/a
• Main Authors: Lv, Ding‐feng, Ying, Qi‐ming, He, Yi‐wen, Liang, Jun, Zhang, Ji‐hong, Lu, Bei‐bei, Qian, Guo‐qing, Chu, Jin‐guo, Weng, Xing‐bei, Chen, Xue‐qin, Mu, Qi‐tian
• Format: Journal Article Web Resource
• Language: English
• Published: United States John Wiley & Sons, Inc 01.02.2021; John Wiley and Sons Inc
• Subjects: Albumin; Alkaline phosphatase; Aspartate aminotransferase; Biomarkers; clinical characteristics; Clinical Laboratory Techniques; Coronaviruses; COVID-19; COVID-19 - diagnosis; COVID-19 - diagnostic imaging; COVID-19 - virology; Diagnosis, Differential; Diarrhea; Differential diagnosis; Electronic medical records; Epidemics; Epidemiology; Fatigue; Female; Fever; Hemoglobin; Hepatitis; Humans; Influenza; Influenza A; Influenza A virus - physiology; Logistic Models; Lymphocytes; Male; Medical diagnosis; Middle Aged; Monocytes; Multivariate Analysis; Pandemics; Pneumonia; Pneumonia - diagnosis; Pneumonia - diagnostic imaging; Pneumonia - virology; Risk Factors; SARS-CoV-2 - physiology; Severe acute respiratory syndrome coronavirus 2; Tomography, X-Ray Computed; China; COVID-19; differential diagnosis; influenza A; pneumonia; clinical characteristics
• ISSN: 0887-8013; 1098-2825
• DOI: 10.1002/jcla.23685

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. 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 monocytes count tend to be helpful for the diagnosis of influenza A pneumonia.