open access

Vol 89, No 3 (2021)
Research paper
Submitted: 2020-11-03
Accepted: 2021-01-27
Published online: 2021-06-30
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Comparison of clinical characteristics and outcomes between COVID-19 pneumonia and H1N1 influenza

Nosheen Nasir1, Iffat Khanum1, Kiren Habib1, Rimsha Ahmed2, Mujahid Hussain3, Zahra Hasan4, Muhammad Irfan3
DOI: 10.5603/ARM.a2021.0049
·
Pubmed: 34196377
·
Adv Respir Med 2021;89(3):254-261.
Affiliations
  1. Medical Student, Aga Khan Medical College, Karachi, Pakistan
  2. Medical College, Aga Khan University, Karachi, Pakistan
  3. Section of Pulmonology, Department of Medicine, Aga Khan University, Karachi, Pakistan
  4. Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan

open access

Vol 89, No 3 (2021)
ORIGINAL PAPERS
Submitted: 2020-11-03
Accepted: 2021-01-27
Published online: 2021-06-30

Abstract

Introduction: The COVID-19 pandemic has been likened to the 2009 H1N1 influenza pandemic. We aim to study the similarities and differences between patients hospitalized with COVID-19 and H1N1 influenza in order to provide better care to patients, particularly during the co-circulation of Influenza A Subtype H1N1 and SARS-CoV-2.
Material and methods: A retrospective cohort study was conducted in order to compare clinical characteristics, complications, and outcomes of hospitalized patients with PCR-confirmed H1N1 influenza pneumonia and COVID-19 at a tertiary care center in Karachi, Pakistan.
Results: A total of 115 patients hospitalized with COVID-19 were compared with 55 patients with H1N1 Influenza A pneumonia. Median age was similar in both COVID-19 patients (54 years) and in patients with H1N1 influenza (59 years), but there was male predominance in COVID-19 patients (OR = 2.95; 95% CI: 1.12–7.79). Patients with COVID-19 pneumonia were 1.34 (95% CI: 1.14–1.62) times more likely to have a greater duration of illness prior to presentation compared to H1N1 influenza patients. COVID-19 patients were 4.59 times (95% CI: 1.32–15.94) more likely to be admitted to a general ward compared to H1N1 pneumonia patients. Moreover, patients with COVID-19 were 7.62 times (95% CI: 2.42–24.00) more likely to be treated with systemic steroids compared to patients with H1N1 pneumonia. The rate of nosocomial infections as well as mortality was similar in both H1N1 and COVID-19 pneumonia.
Conclusion: Our study found a male predominance and longer duration of illness in hospitalized patients with COVID-19 compared to H1N1 influenza patients but no difference in outcomes with either infection.

Abstract

Introduction: The COVID-19 pandemic has been likened to the 2009 H1N1 influenza pandemic. We aim to study the similarities and differences between patients hospitalized with COVID-19 and H1N1 influenza in order to provide better care to patients, particularly during the co-circulation of Influenza A Subtype H1N1 and SARS-CoV-2.
Material and methods: A retrospective cohort study was conducted in order to compare clinical characteristics, complications, and outcomes of hospitalized patients with PCR-confirmed H1N1 influenza pneumonia and COVID-19 at a tertiary care center in Karachi, Pakistan.
Results: A total of 115 patients hospitalized with COVID-19 were compared with 55 patients with H1N1 Influenza A pneumonia. Median age was similar in both COVID-19 patients (54 years) and in patients with H1N1 influenza (59 years), but there was male predominance in COVID-19 patients (OR = 2.95; 95% CI: 1.12–7.79). Patients with COVID-19 pneumonia were 1.34 (95% CI: 1.14–1.62) times more likely to have a greater duration of illness prior to presentation compared to H1N1 influenza patients. COVID-19 patients were 4.59 times (95% CI: 1.32–15.94) more likely to be admitted to a general ward compared to H1N1 pneumonia patients. Moreover, patients with COVID-19 were 7.62 times (95% CI: 2.42–24.00) more likely to be treated with systemic steroids compared to patients with H1N1 pneumonia. The rate of nosocomial infections as well as mortality was similar in both H1N1 and COVID-19 pneumonia.
Conclusion: Our study found a male predominance and longer duration of illness in hospitalized patients with COVID-19 compared to H1N1 influenza patients but no difference in outcomes with either infection.

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Keywords

COVID-19, influenza A subtype H1N1, pneumonia

About this article
Title

Comparison of clinical characteristics and outcomes between COVID-19 pneumonia and H1N1 influenza

Journal

Advances in Respiratory Medicine

Issue

Vol 89, No 3 (2021)

Article type

Research paper

Pages

254-261

Published online

2021-06-30

DOI

10.5603/ARM.a2021.0049

Pubmed

34196377

Bibliographic record

Adv Respir Med 2021;89(3):254-261.

Keywords

COVID-19
influenza A subtype H1N1
pneumonia

Authors

Nosheen Nasir
Iffat Khanum
Kiren Habib
Rimsha Ahmed
Mujahid Hussain
Zahra Hasan
Muhammad Irfan

References (24)
  1. Worldometer. COVID-19 Coronavirus Pandemic. 2020. Available online: www.worldometers.info/coronavirus/. [Last accessed: 27.01.2021].
  2. Smith GJD, Vijaykrishna D, Bahl J, et al. Origins and evolutionary genomics of the 2009 swine-origin H1N1 influenza A epidemic. Nature. 2009; 459(7250): 1122–1125.
  3. World Health Organization. Swine influenza 2009. Available online: www.who.int/mediacentre/news/statements/2009/h1n1_20090425/en/. [Last accessed at: 27.01.2021].
  4. Iuliano AD, Roguski KM, Chang HH. Estimates of global seasonal influenza-associated respiratory mortality: a modelling study. Lancet. 2018; 391: 1285–1300.
  5. Prevention CfDC. 2009 H1N1 Pandemic (H1N1pdm09 virus). 2019. Available online: www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html. [Last accessed: 27.01.2021].
  6. Karageorgopoulos DE, Vouloumanou EK, Korbila IP, et al. Age distribution of cases of 2009 (H1N1) pandemic influenza in comparison with seasonal influenza. PLoS One. 2011; 6(7): e21690.
  7. Wang Q, Zhang T, Zhu H, et al. Characteristics of and public health emergency responses to COVID-19 and H1N1 outbreaks: a case-comparison study. Int J Environ Res Public Health. 2020; 17(12).
  8. Ragab D, Salah Eldin H, Taeimah M, et al. The COVID-19 cytokine storm; what we know so far. Front Immunol. 2020; 11: 1446.
  9. Li SH, Hsieh MJ, Lin SW, et al. Outcomes of severe H1N1 pneumoniae: A retrospective study at intensive care units. J Formos Med Assoc. 2020; 119(1 Pt 1): 26–33.
  10. World Health Organization. Q&A: influenza and COVID-19 — similarities and differences. 2020. Available online: www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-similarities-and-differences-covid-19-and-influenza. [Last accessed: 27.01.2021].
  11. Shen C, Tan M, Song X, et al. Comparative analysis of early-stage clinical features between COVID-19 and influenza a H1N1 virus pneumonia. Front Public Health. 2020; 8: 206.
  12. Cao B, Li XW, Mao Yu, et al. Clinical features of the initial cases of 2009 pandemic influenza a (H1N1) virus infection in China. N Engl J Med. 2009; 361(26): 2507–2517.
  13. Haitao Tu, Vermunt JV, Abeykoon J, et al. COVID-19 and sex differences: mechanisms and biomarkers. Mayo Clin Proc. 2020; 95(10): 2189–2203.
  14. Dabanch J, Perret C, Najera M, et al. Age as risk factor for death from pandemic (H1N1) 2009, Chile. Emerg Infect Dis. 2011; 17(7): 1256–1258.
  15. Tang X, Du RH, Wang R, et al. Comparison of hospitalized patients with ARDS caused by COVID-19 and H1N1. Chest. 2020; 158(1): 195–205.
  16. Zayet S, Kadiane-Oussou NJ, Lepiller Q, et al. Clinical features of COVID-19 and influenza: a comparative study on Nord Franche-Comte cluster. Microbes Infect. 2020; 22(9): 481–488.
  17. Yin Z, Kang Z, Yang D, et al. A comparison of clinical and chest CT findings in patients with influenza a (H1N1) virus infection and coronavirus disease (COVID-19). AJR Am J Roentgenol. 2020; 215(5): 1065–1071.
  18. Schoen K, Horvat N, Guerreiro NFC, et al. Spectrum of clinical and radiographic findings in patients with diagnosis of H1N1 and correlation with clinical severity. BMC Infect Dis. 2019; 19(1): 964.
  19. Zhao W, Zhong Z, Xie X, et al. Relation between chest CT findings and clinical conditions of coronavirus disease (COVID-19) pneumonia: a multicenter study. AJR Am J Roentgenol. 2020; 214(5): 1072–1077.
  20. Ozaras R, Cirpin R, Duran A, et al. Influenza and COVID-19 coinfection: Report of six cases and review of the literature. J Med Virol. 2020; 92(11): 2657–2665.
  21. Mei Y, Weinberg SE, Zhao L, et al. Risk stratification of hospitalized COVID-19 patients through comparative studies of laboratory results with influenza. EClinicalMedicine. 2020; 26: 100475.
  22. Lansbury LE, Rodrigo C, Leonardi-Bee Jo, et al. Corticosteroids as adjunctive therapy in the treatment of influenza. Cochrane Database Syst Rev. 2019; 2(2): CD010406–e9e106.
  23. Dexamethasone in hospitalized patients with COVID-19. New England Journal of Medicine. 2021; 384(8): 693–704.
  24. Barlow GD. BSAC Council. Swine flu and antibiotics. J Antimicrob Chemother. 2009; 64(5): 889–894.

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