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

• Published in: Virology journal Vol. 21; no. 1; pp. 251 - 10
• Main Authors: Iyadorai, Thevambiga, Lim, Sin How, Wong, Pui Li, Sii, Hoe Leong, P'ng, Chun Keat, Ee, Soon Sean, Tan, Maw Pin, Hanafi, Nik Sherina, Ng, Kim Tien, Chook, Jack Bee, Takebe, Yutaka, Chan, Kok-Gan, Singh, Sarbhan, Sam, I-Ching, Tee, Kok Keng
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 08-10-2024; BioMed Central; BMC
• Subjects: Adolescent; Adult; Aged; Care and treatment; Clinical symptom; Common Cold - epidemiology; Common Cold - virology; Common cold coronaviruses; Comorbidity; Coronavirus - isolation & purification; Diagnosis; Disease burden; Female; Hospitalization - statistics & numerical data; Humans; Influenza virus; Influenza, Human - epidemiology; Influenza, Human - virology; Male; Middle Aged; Orthomyxoviridae - isolation & purification; Outpatients; Outpatients - statistics & numerical data; Primary health care; Respiratory tract diseases; Respiratory Tract Infections - epidemiology; Respiratory Tract Infections - virology; Retrospective Studies; Tertiary Care Centers - statistics & numerical data; Young Adult; Malaysia; Clinical symptom; Comorbidity; Influenza virus; Disease burden; Common cold coronaviruses
• ISSN: 1743-422X; 1743-422X
• DOI: 10.1186/s12985-024-02524-6

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.
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.
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).
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.