Clinical characteristics of COVID-19 and its comparison with influenza pneumonia

Acta Clin Belg. 2020 Oct;75(5):348-356. doi: 10.1080/17843286.2020.1798668. Epub 2020 Jul 29.


Objectives: To recognise clinical features of COVID-19 pneumonia and its differences from influenza pneumonia.

Methods: 246 patients were enrolled into COVID-19 cohort and 120 patients into influenza cohort. All data were collected and analysed retrospectively. The variables under focus included demographic, epidemiological, clinical, laboratory and imaging characteristics of COVID-19 pneumonia and comparison were made with influenza pneumonia.

Results: The COVID-19 cohort included 53.25% female and 46.75% male. Their main symptom was fever; while 28.05% of patients had only initially fever; 21.54% of them remained feverless. After excluding prior kidney diseases, some patients showed abnormal urinalysis (32.11%), elevated blood creatinine (15.04%) and blood urea nitrogen (19.11%). Typical CT features included ground glass opacity, consolidation and band opacity, which could present as characteristic 'bat wing sign'. Our data showed that male, aged 65 or above, smoking, with comorbidities including diabetes, cardiovascular and kidney diseases, would experience more severe COVID-19 pneumonia. In comparison, COVID-19 cohort showed significantly higher incidence of clustering; the influenza cohort showed higher rate of fever. Both cohorts showed reduced lymphocyte numbers; however, 6 influenza patients showed lymphocytes increased, which was statistical significant compared with COVID-19 cohort. Also, influenza cohort displayed higher white blood cell counts and PCT values.

Conclusion: There is no significant gender difference in the incidence of COVID-19 pneumonia. It predominantly affects the lung as well as the kidney. Age, smoking and comorbidities could contribute to disease severity. Although COVID-19 is more infectious, the rate of secondary bacterial infection is lower than influenza.

Keywords: COVID-19 pneumonia; clinical features; imaging features; influenza pneumonia.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / complications
  • Coronavirus Infections / diagnosis*
  • Diagnosis, Differential
  • Female
  • Humans
  • Influenza, Human / complications
  • Influenza, Human / diagnosis*
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / virology*
  • Retrospective Studies
  • SARS-CoV-2
  • Symptom Assessment
  • Tomography, X-Ray Computed
  • Young Adult