CLINICAL AND LABORATORY CHARACTERISTICS OF LETHAL CASES OF PANDEMIC INFLUENZA А/H1N1 IN COMPARISON WITH SEVERE FORMS OF COVID-19

Abstract

In the current epidemic season, the circulation of influenza viruses continues, in particular A – A (H3N2) and A (H1N1) pdm09, as well as influenza B virus, mainly (98 %) of the B/Victoria line. According to the Public Health Center of the Ministry of Health of Ukraine, the level of influenza vaccination remains low, accounting for about 0.6 % of the population of Ukraine, and among occupational and epidemiological risk groups – 22.8 %. In modern conditions, the simultaneous circulation of influenza viruses and SARS-CoV-2 can lead to difficulties in differential diagnosis and treatment.

The aim of the work. Comparison of clinical and laboratory features of severe influenza complicated by pneumonia caused by pandemic influenza virus A (H1N1) pdm09 in the epidemic season of 2015/2016 OIKL Kharkiv with COVID-19 according to clinical and laboratory data.

Patients and research methods. The analysis of clinical symptoms and laboratory examination data of 19 patients with influenza complicated by community-acquired pneumonia of the IV clinical group, who were treated in the OKIL of Kharkiv, and their comparison with those in patients with COVID-19 according to the literature.

Results and discussion. Among the studied patients, men predominated – 12 people (63.2 %) aged (50.7±11.9). The predominant number had comorbidities. At the beginning of the disease, moderate weakness, headache, fever, minor catarrhal phenomena and, as a result, delayed hospitalization prevailed. From 3–4 days of the disease the condition significantly worsened, shortness of breath and cyanosis joined. Typical initial symptoms of COVID-19 are varying degrees of fever (73 %), unproductive cough (59 %), and shortness of breath. Computed tomography of the lungs plays an important role in the early diagnosis of severe forms of COVID-19.

Conclusions. In patients with COVID-19 and severe influenza, there is mostly an acute onset of the disease, which was accompanied by moderate weakness, headache and fever up to 38 °C. Upper airway lesions were characterized by symptoms of pharyngitis. With the flu there is a delay in seeking medical attention and admission to the hospital for (6.2±1.5) days from the onset of the disease. The severity of the disease with influenza is due to the accession of community-acquired pneumonia, in contrast to COVID-19, where the typical features are diffuse, mostly subpleural lung damage. Vaccination of people at risk before the start of the epidemic season is necessary to prevent severe complications of influenza caused by the pandemic A/H1N1pdm virus in a COVID-19 pandemic.