tetano
Editor, Senior Moderator
Clin Infect Dis
. 2022 Apr 20;ciac314.
doi: 10.1093/cid/ciac314. Online ahead of print.
Comparison of hospitalized COVID-19 and influenza patients requiring supplemental oxygen in a cohort study: clinical impact and resource consumption
Inmaculada López Montesinos[SUP] 1 [/SUP], Itziar Arrieta-Aldea[SUP] 1 [/SUP], Aitor Dicastillo[SUP] 2 [/SUP], Flavio Zuccarino[SUP] 3 [/SUP], Luisa Sorli[SUP] 1 [/SUP], Roberto Guerri-Fernández[SUP] 1 [/SUP], Isabel Arnau-Barrés[SUP] 4 [/SUP], Maria Milagro Montero[SUP] 1 [/SUP], Ana Siverio-Parès[SUP] 5 [/SUP], Xavier Durán[SUP] 6 [/SUP], Maria Del Mar Arenas[SUP] 1 [/SUP], Ariadna Brasé Arnau[SUP] 7 [/SUP], Esperanza Cañas-Ruano[SUP] 1 [/SUP], Silvia Castañeda[SUP] 1 [/SUP], Ignacio Domingo Kamber[SUP] 7 [/SUP], Joan Gómez-Junyent[SUP] 1 [/SUP], Iván Pelegrín[SUP] 1 [/SUP], Francisca Sánchez Martínez[SUP] 1 [/SUP], Elena Sendra[SUP] 1 [/SUP], Lucía Suaya Leiro[SUP] 7 [/SUP], Judit Villar-García[SUP] 1 [/SUP], Xavier Nogués[SUP] 7 [/SUP], Santiago Grau[SUP] 8 [/SUP], Hernando Knobel[SUP] 1 [/SUP], Silvia Gomez-Zorrilla[SUP] 1 [/SUP], Juan Pablo Horcajada[SUP] 1 [/SUP], COVID-MAR Group
Affiliations
Abstract
Background: To compare clinical characteristics, outcomes, and resource consumption of patients with COVID-19 and seasonal influenza requiring supplemental oxygen.
Methods: Retrospective cohort study conducted at a tertiary-care hospital. Patients admitted due to seasonal influenza between 2017 and 2019, or with COVID-19 between March and May 2020 requiring supplemental oxygen were compared. Primary outcome: 30-day mortality. Secondary outcomes: 90-day mortality and hospitalization costs. Attempted sample size to detect an 11% difference in mortality was 187 patients per group.
Results: COVID-19 cases were younger (median years, 67 (IQR 54-78) vs 76 (IQR 64-83); p < 0.001) and more frequently overweight whereas influenza cases had more hypertension, immunosuppression, and chronic heart, respiratory and renal disease. Compared to influenza, COVID-19 cases had more pneumonia (98% vs 60%, <0.001), higher MEWS and CURB-65 scores and were more likely to show worse progression on the WHO ordinal scale (33% vs 4%; p < 0.001). The 30-day mortality rate was higher for COVID-19 than for influenza: 15% vs 5% (p = 0.001). The median age of non-surviving cases was 81 (IQR 74-88) and 77.5 (IQR 65-84) (p = 0.385), respectively. COVID-19 was independently associated with 30-day (HR 4.6, 95%CI, 2-10.4) and 90-day (HR 5.2, 95%CI, 2.4-11.4) mortality. Sensitivity and subgroup analyses, including a subgroup considering only patients with pneumonia, did not show different trends. Regarding resource consumption, COVID-19 patients had longer hospital stays and higher critical care, pharmacy, and complementary test costs.
Conclusions: Although influenza patients were older and had more comorbidities, COVID-19 cases requiring supplemental oxygen on admission had worse clinical and economic outcomes.
Keywords: COVID-19; flu; hospital costs; mortality; pandemic; resource consumption.
. 2022 Apr 20;ciac314.
doi: 10.1093/cid/ciac314. Online ahead of print.
Comparison of hospitalized COVID-19 and influenza patients requiring supplemental oxygen in a cohort study: clinical impact and resource consumption
Inmaculada López Montesinos[SUP] 1 [/SUP], Itziar Arrieta-Aldea[SUP] 1 [/SUP], Aitor Dicastillo[SUP] 2 [/SUP], Flavio Zuccarino[SUP] 3 [/SUP], Luisa Sorli[SUP] 1 [/SUP], Roberto Guerri-Fernández[SUP] 1 [/SUP], Isabel Arnau-Barrés[SUP] 4 [/SUP], Maria Milagro Montero[SUP] 1 [/SUP], Ana Siverio-Parès[SUP] 5 [/SUP], Xavier Durán[SUP] 6 [/SUP], Maria Del Mar Arenas[SUP] 1 [/SUP], Ariadna Brasé Arnau[SUP] 7 [/SUP], Esperanza Cañas-Ruano[SUP] 1 [/SUP], Silvia Castañeda[SUP] 1 [/SUP], Ignacio Domingo Kamber[SUP] 7 [/SUP], Joan Gómez-Junyent[SUP] 1 [/SUP], Iván Pelegrín[SUP] 1 [/SUP], Francisca Sánchez Martínez[SUP] 1 [/SUP], Elena Sendra[SUP] 1 [/SUP], Lucía Suaya Leiro[SUP] 7 [/SUP], Judit Villar-García[SUP] 1 [/SUP], Xavier Nogués[SUP] 7 [/SUP], Santiago Grau[SUP] 8 [/SUP], Hernando Knobel[SUP] 1 [/SUP], Silvia Gomez-Zorrilla[SUP] 1 [/SUP], Juan Pablo Horcajada[SUP] 1 [/SUP], COVID-MAR Group
Affiliations
- PMID: 35442442
- DOI: 10.1093/cid/ciac314
Abstract
Background: To compare clinical characteristics, outcomes, and resource consumption of patients with COVID-19 and seasonal influenza requiring supplemental oxygen.
Methods: Retrospective cohort study conducted at a tertiary-care hospital. Patients admitted due to seasonal influenza between 2017 and 2019, or with COVID-19 between March and May 2020 requiring supplemental oxygen were compared. Primary outcome: 30-day mortality. Secondary outcomes: 90-day mortality and hospitalization costs. Attempted sample size to detect an 11% difference in mortality was 187 patients per group.
Results: COVID-19 cases were younger (median years, 67 (IQR 54-78) vs 76 (IQR 64-83); p < 0.001) and more frequently overweight whereas influenza cases had more hypertension, immunosuppression, and chronic heart, respiratory and renal disease. Compared to influenza, COVID-19 cases had more pneumonia (98% vs 60%, <0.001), higher MEWS and CURB-65 scores and were more likely to show worse progression on the WHO ordinal scale (33% vs 4%; p < 0.001). The 30-day mortality rate was higher for COVID-19 than for influenza: 15% vs 5% (p = 0.001). The median age of non-surviving cases was 81 (IQR 74-88) and 77.5 (IQR 65-84) (p = 0.385), respectively. COVID-19 was independently associated with 30-day (HR 4.6, 95%CI, 2-10.4) and 90-day (HR 5.2, 95%CI, 2.4-11.4) mortality. Sensitivity and subgroup analyses, including a subgroup considering only patients with pneumonia, did not show different trends. Regarding resource consumption, COVID-19 patients had longer hospital stays and higher critical care, pharmacy, and complementary test costs.
Conclusions: Although influenza patients were older and had more comorbidities, COVID-19 cases requiring supplemental oxygen on admission had worse clinical and economic outcomes.
Keywords: COVID-19; flu; hospital costs; mortality; pandemic; resource consumption.