Comparison of acute respiratory distress syndrome in patients with COVID-19 and influenza A (H7N9) virus infection

•Patients with H7N9- acute respiratory distress syndrome (ARDS) showed a more acute disease course and severity.•Disseminated intravascular coagulation was more common in patients with COVID-19-ARDS.•The main causes of death between H7N9-ARDS and COVID-19-ARDS were different.•This is the first study to compare clinical features between the two diseases. We aimed to compared the clinical features of acute respiratory distress syndrome (ARDS) induced by COVID-19 and H7N9 virus infections. Clinical data of 100 patients with COVID-19 and 46 patients with H7N9 were retrospectively analyzed. Elevated inflammatory indices and coagulation disorders were more common in COVID-19-ARDS group than in the H7N9-ARDS group. The median interval from illness onset to ARDS development was shorter in H7N9-ARDS. The PaO2/FiO2 level was lower in H7N9-ARDS, whereas the Sepsis-related Organ Failure Assessment score was higher in COVID-19-ARDS. The proportion of patients with disseminated intravascular coagulation and liver injury in COVID-19-ARDS and H7N9-ARDS was 45.5% versus 3.1% and 28.8% versus 50%, respectively (P