Introduction
Methods
Selection criteria
Data collection
Data analysis
Results
Patient characteristics
Monthly incidence of the SARS-CoV-2, RSV, and influenza A infections among the hospitalized children
SARS-Cov-2 (n = 351) | Influenza A (n = 671) | RSV (n = 398) | H (n = 243) | X2/F | P-value | ||
---|---|---|---|---|---|---|---|
0 to 6 months (n = 235) | Female | 74 | 6 | 22 | 6 | 6.245 | 0.100 |
Male | 80 | 16 | 29 | 2 | |||
Mean age(y) | 0.20 ± 0.12ac | 0.27 ± 0.10 | 0.23 ± 0.12 | 0.29 ± 0.08 | 4.408 | 0.005** | |
no./total no. (%) | 154/235(65.5) | 22/235(9.4) | 51/235(21.7) | 8/235(3.4) | |||
6 to 24 months (n = 428) | Female | 38 | 49 | 62 | 39 | 0.935 | 0.817 |
Male | 57 | 61 | 78 | 44 | |||
Mean age(y) | 0.86 ± 0.22 | 0.87 ± 0.18 | 0.83 ± 0.19 | 0.82 ± 0.21 | 3.514 | 0.319 | |
no./total no. (%) | 95/428(22.2) | 110/428(225.7) | 140/428(32.7) | 83/428(19.4) | |||
2 to 6 years (n = 665) | Female | 31 | 126 | 97 | 38 | 3.321 | 0.345 |
Male | 35 | 171 | 105 | 62 | |||
Mean age(y) | 3.23 ± 1.13b | 3.49 ± 1.06 | 2.70 ± 0.70 | 3.14 ± 0.98 | 69.035 | 0.000** | |
no./total no. (%) | 66/665(9.9) | 297/665(44.7) | 202/665(30.4) | 100/665(15.0) | |||
6 to 18 years (n = 335) | Female | 17 | 119 | 4 | 26 | 1.951 | 0.583 |
Male | 19 | 123 | 1 | 26 | |||
Mean age(y) | 9.92 ± 2.89abc | 8.00(6.00,9.00) | 6.80 ± 1.10 | 8.19 ± 2.12 | 22.328 | 0.000** | |
no./total no. (%) | 36/335(10.7) | 242/335(72.2) | 5/335(1.5) | 52/335(15.5) | |||
0 to 18 years (n = 1663) | Female | 160 | 300 | 185 | 109 | 0.349 | 0.951 |
Male | 191 | 371 | 213 | 134 | |||
Mean age(y) | 1.94 ± 3.10ac | 4.51 ± 2.97 | 1.78 ± 1.28 | 3.33 ± 2.99 | 114.913 | 0.000** | |
no./total no. (%) | 351/1663(21.1) | 671/1663(40.3) | 398/1663(23.9) | 243/1663(14.6) |
Comparison of routine blood parameters among the infected groups and H-group for the four age categories
Parameters | SARS-CoV-2 (n = 154) | Influenza A (n = 22) | RSV (n = 51) | H-Group (n = 8) | F/H | p-value |
---|---|---|---|---|---|---|
WBC (109/L) | 7.65 ± 2.79b | 7.37 ± 2.95 | 9.14 ± 2.75 | 7.58 ± 1.02 | 15.159 | 0.002** |
NEU (109/L) | 1.59 (0.94,1.62) | 1.16 (0.63,1.79) | 1.93 (1.48,2.54) | 1.42 ± 0.52 | 13.464 | 0.004** |
LYM (109/L) | 4.50 ± 2.45 b | 5.16 ± 2.22 | 5.59 ± 1.6 | 5.38 ± 0.99 | 13.804 | 0.003** |
RBC (1012/L) | 3.89 ± 0.58 | 4.08 ± 0.62 | 3.84 ± 0.4 | 4.33 ± 0.5 | 2.634 | 0.051 |
Hb (g/L) | 114.83 ± 15.95 | 112.86 ± 12.96 | 112.43 ± 14.33 | 115.38 ± 9.23 | 1.094 | 0.779 |
PLT (109/L) | 306.66 ± 96.18bc | 327.27 ± 87.68 | 438.77 ± 141.01 | 485.50 ± 122.37 | 45.720 | 0.000** |
NLR | 0.37 (0.18,1.05)a | 0.18 (0.13,0.33) | 0.35 (0.23,0.45) | 0.27 ± 0.11 | 9.067 | 0.028* |
LMR | 5.37 (2.64,9.51) abc | 9.91 ± 5.79 | 8.13 ± 4.11 | 13.13 ± 3.87 | 22.926 | 0.000** |
LYM*PLT | 1408.8 ± 951.54 bc | 1807.15 ± 1098.43 | 2529.28 ± 1282.11 | 2585.89 ± 656.67 | 40.855 | 0.000** |
MPV/PLT | 0.031 (0.024,0.041) bc | 0.031 (0.024,0.035) | 0.022 (0.016,0.028) | 0.0118 ± 0.005 | 43.944 | 0.000** |
Parameters | SARS-Cov-2 (n = 95) | Influenza A (n = 110) | RSV (n = 140) | H-Group (n = 83) | F/H | p-Value |
---|---|---|---|---|---|---|
WBC (109/L) | 7.43 ± 2.97 b | 7.18 ± 2.6 | 9.1 ± 2.93 | 8.06 ± 1.2 | 36.036 | 0.000** |
NEU (109/L) | 2.45 ± 1.71 | 1.98 ± 1.5 | 2.57 ± 1.4 | 1.76 ± 0.62 | 22.312 | 0.000** |
LYM (109/L) | 4.29 ± 2.28bc | 4.45 ± 2.43 | 5.52 ± 2.19 | 5.43 ± 1.09 | 28.569 | 0.000** |
RBC (1012/L) | 4.48 ± 0.38 bc | 4.52 ± 0.34 | 4.64 ± 0.37 | 4.62 ± 0.31 | 5.320 | 0.001** |
Hb (g/L) | 116.98 ± 10.07 | 118.47 ± 9.3 | 118.27 ± 9.84 | 119.99 ± 8.99 | 6.126 | 0.106 |
PLT (109/L) | 261.96 ± 87.49 bc | 247.63 ± 80.08 | 339.87 ± 91.11 | 337.58 ± 78.03 | 95.016 | 0.000** |
NLR | 0.52 (0.25,0.86)c | 0.32 (0.14,1.06) | 0.41 (0.28,0.69) | 0.35 ± 0.16 | 15.922 | 0.001** |
LMR | 8.31 ± 5.2 c | 9.52 ± 6.75 | 7.64 (5.30,10.49) | 11.57 ± 3.82 | 32.768 | 0.000** |
LYM*PLT | 1199.91 ± 848.8 bc | 1177.63 ± 927.92 | 1935.77 ± 1046.08 | 1849.68 ± 629.7 | 73.001 | 0.000** |
MPV/PLT | 0.039 ± 0.016 bc | 0.041 ± 0.015 | 0.029 ± 0.009 | 0.028 ± 0.008 | 90.864 | 0.000** |
Parameters | SARS-Cov-2 (n = 66) | Influenza A (n = 297) | RSV (n = 202) | H-Group (n = 100) | F/H | p-Value |
---|---|---|---|---|---|---|
WBC (109/L) | 6.82 ± 3.01a | 5.41 ± 2.1 | 6.99 ± 2.31 | 6.81 ± 1.23 | 88.778 | 0.000** |
NEU (109/L) | 3.03 ± 2.11 | 2.44 ± 1.82 | 3.05 ± 1.84 | 2.42 ± 0.84 | 23.140 | 0.000** |
LYM (109/L) | 2.58 ± 1.31bc | 2.37 ± 1.14 | 3.15 ± 1.22 | 3.72 ± 0.9 | 108.943 | 0.000** |
RBC (1012/L) | 4.48 ± 0.36 | 4.49 ± 0.31 | 4.47 ± 0.31 | 4.58 ± 0.29 | 10.803 | 0.013* |
Hb (g/L) | 122.49 ± 7.97 | 123.82 ± 7.93 | 121.75 ± 7.4 | 125.3 ± 7.46 | 16.708 | 0.001** |
PLT (109/L) | 229.22 ± 57.49abc | 205.98 ± 56.66 | 257.71 ± 58.96 | 301.51 ± 68.08 | 164.438 | 0.000** |
NLR | 1.04 (0.58,1.84)c | 0.83 (0.35,1.98) | 0.91 (0.52,1.47) | 0.63 (0.47,0.85) | 17.281 | 0.001** |
LMR | 5.00 ± 3.94 abc | 5.46 (2.95,8.34) | 6.17 ± 3.34 | 8.83 ± 3.05 | 66.021 | 0.000** |
LYM*PLT | 602.07 ± 370.23bc | 498.06 ± 304.63 | 830.84 ± 419.56 | 1130.76 ± 393.6 | 192.048 | 0.000** |
MPV/PLT | 0.041 (0.035,0.051) abc | 0.049 ± 0.016 | 0.038 ± 0.011 | 0.031 ± 0.010 | 154.539 | 0.000** |
Parameters | SARS-Cov-2 (n = 36) | Influenza A (n = 242) | RSV (n = 5) | H-Group (n = 52) | F/H | p-Value |
---|---|---|---|---|---|---|
WBC (109/L) | 6.23 ± 2.54a | 4.54 ± 1.91 | 7.65 ± 1.27 | 6.98 ± 1.32 | 77.101 | 0.000** |
NEU (109/L) | 3.68 ± 2.36 a | 2.36 ± 1.91 | 3.62 ± 0.99 | 3.44 ± 1.09 | 45.048 | 0.000** |
LYM (109/L) | 1.87 ± 1.07c | 1.73 ± 0.83 | 3.22 ± 1.12 | 2.88 ± 0.7 | 67.298 | 0.000** |
RBC (1012/L) | 4.70 ± 0.45b | 4.58 ± 0.35 | 4.27 ± 0.22 | 4.66 ± 0.38 | 2.957 | 0.033* |
Hb (g/L) | 131.18 ± 11.15 | 129.86 ± 9.05 | 122.6 ± 5.94 | 129.29 ± 10.28 | 1.275 | 0.283 |
PLT (109/L) | 231.03 ± 59.46ac | 201.24 ± 57.49 | 285.4 ± 30.5 | 286.9 ± 50.64 | 81.622 | 0.000** |
NLR | 1.65 (1.03,3.37) a | 0.90 (0.52,2.29) | 1.25 ± 0.61 | 1.09 (0.88,1.52) | 11.088 | 0.011** |
LMR | 4.01 ± 2.25 c | 5.32 ± 3.42 | 5.94 ± 3.64 | 7.21 ± 2.31 | 32.415 | 0.000** |
LYM*PLT | 460.31 ± 315.52 c | 325.62 (182.79,474.16) | 917.99 ± 326.24 | 835.38 ± 272.51 | 94.392 | 0.000** |
MPV/PLT | 0.045 ± 0.018ac | 0.049 (0.040,0.061) | 0.035 ± 0.006 | 0.032 (0.027,0.038) | 75.164 | 0.000** |
Diagnostic value of the routine blood parameters for distinguishing between the infected and healthy children
AUC (95%CI) | Sensitivity (%) | Specificity (%) | Cut-off | |
---|---|---|---|---|
SARS-CoV-2 vs. H-Group | ||||
LMR | 0.860(0.797–0.909) | 69.5 | 100.0 | 8.58 |
LYM*PLT | 0.860(0.796–0.909) | 70.8 | 100.0 | 1742.3 |
MPV/PLT | 0.911(0.856–0.950) | 77.3 | 100.0 | 0.0235 |
Platelet count | 0.881(0.821–0.927) | 72.1 | 100.0 | 369*109/L |
SARS-CoV-2 vs. Influenza A | ||||
NLR | 0.662(0.587–0.731) | 55.2 | 77.3 | 0.312 |
LMR | 0.678(0.604–0.746) | 44.8 | 86.4 | 4.52 |
SARS-Cov-2 vs. RSV | ||||
LYM*PLT | 0.767(0.703–0.823) | 66.9 | 74.5 | 1642.2 |
MPV/*PLT | 0.760(0.696–0.817) | 51.9 | 88.2 | 0.0306 |
Platelet count | 0.778(0.715–0.833) | 57.8 | 86.3 | 315*109/L |
AUC (95%Cl) | Sensitivity (%) | Specificity (%) | Cut-off | |
---|---|---|---|---|
SARS-Cov-2 vs. H-Group | ||||
LMR | 0.695(0.622–0.762) | 43.2 | 97.6 | 6.09 |
LYM*PLT | 0.744(0.673–0.806) | 61.1 | 85.5 | 1246.3 |
MPV/PLT | 0.752(0.681–0.813) | 61.1 | 79.5 | 0.0325 |
Platelet count | 0.749(0.679–0.811) | 47.4 | 92.8 | 242*109/L |
SARS-Cov-2 vs. Influenza A | ||||
NLR | 0.564(0.493–0.633) | 66.3 | 50.9 | 0.3245 |
Neutrophil count | 0.582(0.511–0.650) | 51.6 | 66.4 | 2.08*109/L |
SARS-Cov-2 vs. RSV | ||||
LYM*PLT | 0.715(0.652–0.772) | 40.0 | 93.6 | 702 |
MPV/*PLT | 0.720(0.658–0.777) | 66.3 | 68.6 | 0.031 |
Platelet count | 0.736(0.674–0.791) | 63.2 | 76.4 | 279*109/L |
AUC (95%Cl) | Sensitivity (%) | Specificity (%) | Cut-off | |
---|---|---|---|---|
SARS-Cov-2 vs. H-Group | ||||
LMR | 0.842 (0.749–0.911) | 77.8 | 82.7 | 4.9138 |
LYM*PLT | 0.810 (0.712–0.886) | 69.4 | 86.5 | 601.6 |
MPV/PLT | 0.733 (0.628–0.821) | 50.0 | 84.6 | 0.0406 |
Lymphocyte count | 0.767 (0.665–0.850) | 61.1 | 88.5 | 2.1*109/L |
Platelet count | 0.752 (0.648–0.838) | 66.7 | 71.2 | 258*109/L |
SARS-Cov-2 vs. Influenza A | ||||
WBC count | 0.697 (0.639–0.750) | 77.8 | 63.6 | 4.61*109/L |
Platelet count | 0.655 (0.596–0.711) | 47.2 | 83.1 | 244*109/L |
MPV/PLT | 0.662 (0.550–0.668) | 69.4 | 68.2 | 0.0428 |
LMR | 0.610 (0.550–0.668) | 77.8 | 50.8 | 4.9138 |
SARS-Cov-2 vs. RSV | ||||
LYM*PLT | 0.839 (0.691–0.935) | 63.9 | 100 | 490.68 |
Lymphocyte count | 0.794 (0.640–0.904) | 61.1 | 100 | 2.1*109/L |
AUC (95%Cl) | Sensitivity (%) | Specificity (%) | Cut-off | |
---|---|---|---|---|
SARS-Cov-2 vs. H-Group | ||||
LMR | 0.813 (0.746–0.870) | 84.8 | 73.0 | 7.3286 |
LYM*PLT | 0.844 (0.779–0.895) | 66.7 | 90.0 | 630.72 |
Platelet count | 0.793 (0.724–0.852) | 77.3 | 76.0 | 260*109/L |
SARS-Cov-2 vs. Influenza A | ||||
WBC count | 0.639 (0.587–0.689) | 69.7 | 51.2 | 5.13*109/L |
Neutrophil count | 0.593 (0.540–0.644) | 56.1 | 62.6 | 2.57*109/L |
Platelet count | 0.625 (0.573–0.675) | 63.6 | 59.9 | 209*109/L |
MPV/PLT | 0.613 (0.561–0.663) | 60.6 | 63.3 | 0.0429 |
SARS-Cov-2 vs. RSV | ||||
RBC count | 0.836 (0.687–0.933) | 66.7 | 100.0 | 4.51*1012/L |