Asuman DEMİRBUĞA, Selda Hançerli TÖRÜN, Özge KABA, Süheyla GÜMÜŞ, Raif YILDIZ, Metin UYSALOL, Sevim MEŞE, Mustafa ÖNEL, Ali AĞAÇFİDAN, Ayper SOMER

Çocuklarda SARS-Cov-2 ve İnfluenza Enfeksiyonunda Semptomdan Tanıya Benzerlikler ve Farklılıklar

Amaç: Bu çalışmada, çocuklarda klinik bulgular, laboratuvar tanısı ve hastalığı önleme açısından influenza enfeksiyonu ve COVID-19 hastalığı arasında ayrım yapan özellikleri gösterirken epidemiyolojik verileri de gözden geçirmek ve sentezlemek amaçlanmıştır. Yöntem: Bu çalışmaya Ekim 2009-Mayıs 2014 yılları arasında hastanede yatan doğrulanmış influenza enfeksiyonu olan (n: 344) ve Nisan 2020-Haziran 2021 tarihleri arasında doğrulanmış COVID-19 (n: 251) nedeniyle yatan hastalar dahil edilmiştir. Bulgular: İnfluenza enfeksiyonu olanlarda yaş, SARS-CoV-2 enfeksiyonuna göre istatistiksel olarak anlamlı küçük saptandı (ort. yaş 6 ± 5.3/13.0 ± 5.3, p <0.001). Ateş, öksürük ve miyalji influenzada en sık semptomlardı (p<0.001; p<0.001, p=0.02). Baş ağrısı hastaneye başvuruda COVID-19 olgularında daha sık bulundu (n=55/251, 21.9%). COVID-19 da lenfopeni, influenza olgularında ise CRP yüksekliği istatistiksel olarak yüksek bulundu(p=0.01/p<0.001). Ortalama hastanede kalış süresi influenzada 6±5 gün (1-90), COVID-19’da 1±4 gün (1-64) bulundu (p<0.001). Erişkinlere kıyasla öksürük ve solunum şikayetlerinin daha az olması, semptomatik ve ciddi vakaların da daha az olması sebebiyle radyolojik görüntülemelere COVID-19 hastalarında daha az ihtiyaç duyulmuştur. Sonuç: COVID-19’un klinik ve epidemiyolojik bulguları influenza ile paralellik göstermekle birlikte, her iki etkenin de dolaşımda devam edeceği düşünülürse her iki hastalığında optimal yönetimini sağlamak önemlidir. Ani başlayan ateş, öksürük, miyalji gibi bulgular influenza açısından uyarıcı olsa da tanı için yeterli olmadığından viral tanı testlerinin kullanımı önemlidir.

Anahtar Kelimeler:

COVID-19, İnfluenza, çocuklar

Similarities and Differences Between SARS-Cov-2 and Influenza Infection from Symptom to Diagnosis in Childhood

Objective: The COVID-19 pandemic and annual influenza epidemic are responsible for thousands of deaths globally. This study was conducted to identify epidemiological aspects while demonstrating features that distinguish between influenza infection and COVID-19 disease in terms of clinical manifestations, laboratory, and prevention. Methods: The patients hospitalized with confirmed influenza between October 2009-May 2014 (n=344) and with confirmed COVID-19 between April 2020-June 2021 (n=251) were enrolled in this study. Results: The age of the patients with influenza infection was statistically significantly younger than the patients with SARS-CoV-2 infection (mean age 6 ± 5.3 years versus 13.0 ± 5.3 years, p <0.001). Fever, cough, and myalgia were the more common symptoms of influenza (p< 0.001; p<0.001, p=0.02). It was found that in cases of COVID-19 (n=55/251, 21.9%), headache complaints were more common at admission. Lymphopenia (n=89/251 35.4%) in COVID-19 and CRP elevation detected in influenza cases (n=201/344 58.4%) were statistically significant (p=0.01/ p<0.001). The mean hospital stay was 6±5 days (1-90 days) in influenza and 1±4 (1-64 days) in COVID-19 (p< 0.001). The radiological investigations were less necessary in children with COVID19 because of the lower overall incidence of infected, symptomatic, and severe cases and the lower presence of cough and respiratory symptoms compared to adults. Conclusions: As the clinical and epidemiological features of COVID-19 have many parallels with influenza, it is important to ensure optimal management of both respiratory diseases as we expect that co-circulation will continue. Clinical findings in children are not sufficient for a definitive diagnosis, so it should be supported by a viral diagnosis test.

Keywords:

COVID-19, influenza, children,

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