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

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

Thevambiga Iyadorai  1 , Sin How Lim  2 , Pui Li Wong  3 , Hoe Leong Sii  3 , Chun Keat P'ng  3 , Soon Sean Ee  3 , Maw Pin Tan  3 , Nik Sherina Hanafi  4 , Kim Tien Ng  5 , Jack Bee Chook  6 , Yutaka Takebe  1   7 , Kok-Gan Chan  8   9 , Sarbhan Singh  10 , I-Ching Sam  1 , Kok Keng Tee  11   12
Affiliations

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

Thevambiga Iyadorai et al. Virol J. .

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.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart depicting test positivity and subsequent inclusion numbers
Fig. 2
Fig. 2
(Un)adjusted regression analysis for health outcomes in patients with ccCoV compared to influenza virus infection. Models were adjusted for gender, age and presence of baseline comorbidities. P < 0.05 is considered statistically significant. Abbreviations: ccCoV, common cold coronaviruses; RTI, respiratory tract infection; OR, odds ratio; CI, confidence interval
See this image and copyright information in PMC

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