Clinical symptoms, comorbidities and health outcomes among outpatients infected with the common cold coronaviruses versus influenza virus

Virol J. 2024 Oct 8;21(1):251. doi: 10.1186/s12985-024-02524-6.

Abstract

Background: Common cold coronaviruses (ccCoVs) and influenza virus are common infectious agents causing upper respiratory tract infections (RTIs). However, clinical symptoms, comorbidities, and health effects of ccCoV infection remain understudied.

Methods: A retrospective study evaluated 3,935 outpatients with acute upper RTI at a tertiary teaching hospital. The presence of ccCoV and influenza virus was determined by multiplex molecular assay. The demographic, clinical symptoms, and health outcomes were compared between patients with ccCoV (n = 205) and influenza (n = 417) infections. Multivariable logistic regression was employed to evaluate predictors and health outcomes over a one-year follow-up.

Results: Sore throat, nasal discharge, headache, and myalgia were more predominant in ccCoV infection; fever was common in influenza. Most patients reported moderate symptoms severity (49.8% ccCoV, 56.1% influenza). Subsequent primary care visits with symptoms of RTI within a year were comparable for both infections (27.3% ccCoV vs. 27.6% influenza). However, patients with influenza reported increased primary care visits for non-RTI episodes and all-cause hospital admission. Baseline comorbidities were associated with increased primary care visits with symptoms of RTI in either ccCoV (adjusted odds ratio [aOR] 2.5; 95% confidence interval [CI] 1.1-5.9; P = 0.034) or influenza (OR 1.9; 95% CI 1.1-3.1; P = 0.017) infections, due probably to the dysregulation of the host immune response following acute infections. In patients infected with influenza infection, dyslipidemia was a predictor for subsequent primary care visits with symptoms of RTI (unadjusted OR 1.8; 95% CI 1.0-3.0; P = 0.040).

Conclusions: Both influenza and ccCoV infection pose significant disease burden, especially in patients with comorbidities. The management of comorbidities should be prioritized to mitigate poor health outcomes in infected individuals.

Keywords: Clinical symptom; Common cold coronaviruses; Comorbidity; Disease burden; Influenza virus.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Common Cold* / epidemiology
  • Common Cold* / virology
  • Comorbidity*
  • Coronavirus / isolation & purification
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Influenza, Human* / epidemiology
  • Influenza, Human* / virology
  • Male
  • Middle Aged
  • Orthomyxoviridae / isolation & purification
  • Outpatients* / statistics & numerical data
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / virology
  • Retrospective Studies
  • Tertiary Care Centers / statistics & numerical data
  • Young Adult