Children in the Shadow of Viruses: Comparative Clinical Outcomes of COVID-19 and Influenza - A Single-center Retrospective Cohort Study

Introduction: Respiratory viruses are the most common cause of morbidity and mortality in children around the world.Unlike other viral respiratory diseases, recommendations for coronavirus disease-2019 (COVID-19) in children are mainly derived from adult data, and it has been difficult to differentiate COVID-19 from influenza by clinical manifestations that are earlier than viral identification.The study aims to compare clinical and laboratory characteristics that will enable healthcare workers to differentiate COVID-19 from influenza.Methods: This retrospective cohort study, conducted at a tertiary academic hospital's pediatric emergency department from January 1, 2019 to December 31, 2021 focused on children with confirmed COVID-19 or influenza.We compared demographics, clinical features, laboratory/radiological findings, reatments, pediatric intensive care unit admissions, length of stay, mortality, and clinical outcomes between COVID-19 and influenza in pediatric populations, providing valuable insights into the two diseases during the specified period.Results: Six hundred and sixty-one children with COVID-19 and 499 children with influenza infection were included.In the vital signs at triage, significantly higher fever, tachypnea, and tachycardia were found in patients with influenza (p=0.001).In terms of chest X-ray (CXR) characteristics, 82.2% of the children in the COVID-19 group had normal CXR (p=0.001) while the children in the influenza group had more patchy involvement (p=0.003) and consolidation (p=0.001).Platelet counts in the COVID-19 group were significantly higher than those in the influenza group (p=0.001).Regarding infection-related biomarkers, the C-reactive protein level in the influenza cohort was significantly higher than in the COVID-19 cohort (4.92 mg/L vs. 0.94 mg/L, p=0.001). zGiri: Solunum yolu virsleri, dnya genelinde ocuklarda morbidite ve mortalitenin en yaygn nedenidir.Dier viral solunum yolu hastalklarndan farkl olarak, ocuklarda koronavirs hastal-2019 (COVID-19) ynelik neriler arlkl olarak yetikin verilerinden elde edilmitir.Ayrca, COVID-19'un influenza ile erken dnemde, viral tan konulmadan nce, klinik belirtilerle ayrt edilmesi zor olmutur.Bu alma, salk alanlarnn COVID-19 ile influenzay ayrt etmelerini salayacak klinik ve laboratuvar zellikleri karlatrmay amalamaktadr.Yntemler: Bu geriye dnk kohort almas,