Published: 5 July 2021

Authors: Pontus Hedberg, John Karlsson Valik, Suzanne van der Werff, Hideyuki Tanushi, Ana Requena Mendez, Fredrik Granath, Max Bell, Johan Mårtensson, Robert Dyrdak, Olof Hertting, Anna Färnert, Anders Ternhag, Pontus Naucler

Source: This abstract has been sourced from NZ Respiratory Research Review Issue 196


    Background An understanding of differences in clinical phenotypes and outcomes COVID-19 compared with other respiratory viral infections is important to optimise the management of patients and plan healthcare. Herein we sought to investigate such differences in patients positive for SARS-CoV-2 compared with influenza, respiratory syncytial virus (RSV) and other respiratory viruses.

    Methods We performed a retrospective cohort study of hospitalised adults and children (≤15 years) who tested positive for SARS-CoV-2, influenza virus A/B, RSV, rhinovirus, enterovirus, parainfluenza viruses, metapneumovirus, seasonal coronaviruses, adenovirus or
    bocavirus in a respiratory sample at admission between 2011 and 2020.

    Results A total of 6321 adult (1721 SARS-CoV-2) and 6379 paediatric (101 SARS-CoV-2) healthcare episodes were included in the study. In adults, SARSCoV-2 positivity was independently associated with younger age, male sex, overweight/obesity, diabetes and hypertension, tachypnoea as well as better haemodynamic measurements, white cell count, platelet count and creatinine values. Furthermore, SARSCoV-2 was associated with higher 30-day mortality as compared with influenza (adjusted HR (aHR) 4.43, 95%CI 3.51 to 5.59), RSV (aHR 3.81, 95%CI 2.72 to 5.34) and other respiratory viruses (aHR 3.46, 95%CI 2.61 to 4.60), as well as higher 90-day mortality, ICU
    admission, ICU mortality and pulmonary embolism in adults. In children, patients with SARS-CoV-2 were older and had lower prevalence of chronic cardiac and respiratory diseases compared with other viruses.

    Conclusions SARS-CoV-2 is associated with more severe outcomes compared with other respiratory viruses, and although associated with specific patient and clinical characteristics at admission, a substantial overlap precludes discrimination based on these characteristics. 

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