The comparison of COVID‐19 vs seasonal influenza in children

Abstract

AbstractBackgroundInfluenza in children has been well described, whereas there has been a paucity of pediatric data regarding COVID‐19. It is crucial for clinicians to differentiate cases of COVID‐19 from cases of influenza because of the upcoming influenza season in the new pandemic era.MethodsThis retrospective study included pediatric patients who were diagnosed with laboratory‐confirmed COVID‐19 between March and September 2020, or seasonal influenza between October 2019 and March 2020.ResultsA total of 315 children were included in this study; 151 were diagnosed with influenza and 164 had confirmed COVID‐19. The median age of patients with COVID‐19 was 10 years (interquartile range [IQR]: 3–15 years), whereas the median age of patients with influenza was 4 years (IQR: 1–6 years) (p = 0.001). In the COVID‐19 group, 6.3% of patients had underlying diseases, the most frequent being neurological conditions (3%). In the influenza group, 20.9% of patients had an underlying disease, the most frequent being asthma (14.5%). Fever (odds ratio [OR]: 20.476; 95% confidence interval [CI]: 2.438–171.995; p = 0.005), dyspnea/tachypnea (OR 13.950; 95% CI: 2.607–74.634; p = 0.002), and increased C‐reactive protein (CRP) (OR: 7.650; 95% CI: 2.094–27.955; p = 0.002) were main predictors of influenza diagnosis in comparison to COVID‐19. Lymphopenia was detected in 43.2% of patients with influenza and 19.9% of patients with COVID‐19 (p = 0.001).ConclusionsThe accurate differentiation between “influenza or COVID‐19” seems possible by evaluating a combination of factors including cough, fever, vomiting, leucopenia, lymphopenia, pneumonia, in pediatric patients with high CRP as well as age.