A comparative study on the clinical features of COVID-19 with non-SARS-CoV-2 respiratory viral infections

J Med Virol. 2021 Mar;93(3):1548-1555. doi: 10.1002/jmv.26486. Epub 2020 Sep 29.


During this coronavirus disease 2019 (COVID-19) pandemic, physicians have the important task of risk stratifying patients who present with acute respiratory illnesses. Clinical presentation of COVID-19, however, can be difficult to distinguish from other respiratory viral infections. Thus, identifying clinical features that are strongly associated with COVID-19 in comparison to other respiratory viruses can aid risk stratification and testing prioritization especially in situations where resources for virological testing and resources for isolation facilities are limited. In our retrospective cohort study comparing the clinical presentation of COVID-19 and other respiratory viral infections, we found that anosmia and dysgeusia were symptoms independently associated with COVID-19 and can be important differentiating symptoms in patients presenting with acute respiratory illness. On the other hand, laboratory abnormalities and radiological findings were not statistically different between the two groups. In comparing outcomes, patients with COVID-19 were more likely to need high dependency or intensive care unit care and had a longer median length of stay. With our findings, we emphasize that epidemiological risk factors and clinical symptoms are more useful than laboratory and radiological abnormalities in differentiating COVID-19 from other respiratory viral infections.

Keywords: COVID-19; anosmia; clinical comparison; dysgeusia; respiratory viruses.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Ageusia / diagnosis
  • Ageusia / virology
  • Anosmia / diagnosis
  • Anosmia / pathology*
  • Anosmia / virology
  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology
  • COVID-19 / pathology*
  • Critical Care / statistics & numerical data
  • Dysgeusia / diagnosis
  • Dysgeusia / pathology*
  • Dysgeusia / virology
  • Female
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Length of Stay
  • Male
  • Middle Aged
  • Respiration, Artificial / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2