Adults (aged 18 or older) who are hospitalized with COVID-19 are at greater risk of complications and death than those with influenza, despite being younger and having fewer chronic illnesses, according to a retrospective study conducted at Hospital del Mar. in Barcelona.
The findings, presented at this year’s European Conference on Clinical Microbiology and Infectious Diseases (ECCMID) in Lisbon, Portugal (23-26 April), indicate that COVID-19 is associated with longer hospital stays and intensive care, and costs nearly twice as much treatment. .
For the study, researchers examined the medical records of 187 patients (median age 76 years, 55% male) who were admitted to hospital with seasonal influenza infection between 2017 and 2019, and 187 patients with COVID-19 (median age 67 years). , 49% male) who were hospitalized during the first wave of the epidemic between March and May 2020, who all required oxygen therapy on admission. In both groups, patients were consecutively enrolled until the desired sample size was reached. The study compared clinical characteristics, outcomes of health care resource use (including length of stay, and admission to intensive care), hospital costs, and mortality.
Influenza patients tended to have more chronic illnesses and problems with activities of daily living than COVID-19 patients, but were less likely to be overweight or obese (BMI 25 kg/m2 or greater).
The analysis found that COVID-19 was associated with an increased risk of severe infection and admission to the intensive care unit (26 .). [14%] Influenza vs 69 [39%] for COVID-19; See table in notes to editors). Additionally, COVID-19 patients were more likely to develop certain complications such as acute kidney injury, blood clots, and moderate to severe acute respiratory distress syndrome (in which the lungs cannot supply vital organs with adequate oxygen); While influenza patients were more likely to have bacterial pneumonia (see table in notes to editors/abstract).
Overall, 29/187 (15%) of COVID-19 patients and 10/187 (5%) of influenza patients died of any cause within 30 days of hospitalization, and the death rate after 90 days was higher (19%; 35/ ) 187 against 6%; 12/187). The authors note that there are no differences in mortality trends between the three seasonal influenza periods studied.
After accounting for potential confounding factors including age, comorbidities, gender, disease severity, presence of pneumonia, and corticosteroid treatment, the researchers found that COVID-19 patients were three times more likely to die within 30 and 90 days of hospitalization than flu patients.
Additional analyzes showed that COVID-19 patients spent more time in hospital (median [median] 14 versus 11 days) and the intensive care unit (17 versus 10 days) compared to influenza patients. Furthermore, the average cost of critical care for COVID-19 patients was almost double that of influenza patients (€21,350 versus €12,082). Pharmaceutical treatment and testing costs were significantly higher in the COVID-19 group.
“Our findings suggest that COVID-19 is much more deadly than influenza,” says lead author Dr. Inmaculada Lopez Montesinos of Hospital del Mar in Barcelona, Spain. “Although influenza patients are older and have more comorbidities, COVID-19 patients have consistently had worse health outcomes and their treatment has been much more expensive. Even for those people lucky enough to survive COVID-19 and be discharged from hospital, you will still Their scars are forever due to the consequences. It is imperative that people are fully vaccinated and boosted against both viruses.”
The authors acknowledge that there are many limitations to their study, including that it was performed in a tertiary care hospital in Spain, so the results may not be generalizable to other populations. They also note that no genotyping studies have been conducted, and while it is very likely that COVID-19 patients were affected by wild type B.1, the results may not reflect the current scenario in which many SARS-CoV-2 variants are circulating. globally. Likewise, the absence of vaccinated COVID-19 patients during the study period may not reflect the current inpatient profile of COVID-19.
The risk of dying from COVID-19 is 3.5 times higher than from the flu
Submitted by the European Society of Clinical Microbiology and Infectious Diseases
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