tetano
Editor, Senior Moderator
J Gen Intern Med
. 2021 Mar 18.
doi: 10.1007/s11606-021-06647-2. Online ahead of print.
Comparison between Patients Hospitalized with Influenza and COVID-19 at a Tertiary Care Center
Michael W Donnino[SUP] 1 2 [/SUP], Ari Moskowitz[SUP] 3 4 [/SUP], Garrett S Thompson[SUP] 3 [/SUP], Stanley J Heydrick[SUP] 3 [/SUP], Rahul D Pawar[SUP] 3 [/SUP], Katherine M Berg[SUP] 4 [/SUP], Shivani Mehta[SUP] 3 [/SUP], Parth V Patel[SUP] 3 [/SUP], Anne V Grossestreuer[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Widespread reports suggest the characteristics and disease course of coronavirus disease 2019 (COVID-19) and influenza differ, yet detailed comparisons of their clinical manifestations are lacking.
Objective: Comparison of the epidemiology and clinical characteristics of COVID-19 patients during the pandemic with those of influenza patients in previous influenza seasons at the same hospital DESIGN: Admission rates, clinical measurements, and clinical outcomes from confirmed COVID-19 cases between March 1 and April 30, 2020, were compared with those from confirmed influenza cases in the previous five influenza seasons (8 months each) beginning September 1, 2014.
Setting: Large tertiary care teaching hospital in Boston, MA PARTICIPANTS: Laboratory-confirmed COVID-19 and influenza inpatients MEASUREMENTS: Patient demographics and medical history, mortality, incidence and duration of mechanical ventilation, incidences of vasopressor support and renal replacement therapy, and hospital and intensive care admissions.
Results: Data was abstracted from medical records of 1052 influenza patients and 582 COVID-19 patients. An average of 210 hospital admissions for influenza occurred per 8-month season compared to 582 COVID-19 admissions over 2 months. The median weekly number of COVID-19 patients requiring mechanical ventilation was 17 (IQR: 4, 34) compared to a weekly median of 1 (IQR: 0, 2) influenza patient (p=0.001). COVID-19 patients were significantly more likely to require mechanical ventilation (31% vs 8%) and had significantly higher mortality (20% vs. 3%; p<0.001 for all). Relatively more COVID-19 patients on mechanical ventilation lacked pre-existing conditions compared with mechanically ventilated influenza patients (25% vs 4%, p<0.001). Pneumonia/ARDS secondary to the virus was the predominant cause of mechanical ventilation in COVID-19 patients (94%) as opposed to influenza (56%).
Limitation: This is a single-center study which could limit generalization.
Conclusion: COVID-19 resulted in more weekly hospitalizations, higher morbidity, and higher mortality than influenza at the same hospital.
Keywords: COVID-19; influenza; mechanical ventilation.
. 2021 Mar 18.
doi: 10.1007/s11606-021-06647-2. Online ahead of print.
Comparison between Patients Hospitalized with Influenza and COVID-19 at a Tertiary Care Center
Michael W Donnino[SUP] 1 2 [/SUP], Ari Moskowitz[SUP] 3 4 [/SUP], Garrett S Thompson[SUP] 3 [/SUP], Stanley J Heydrick[SUP] 3 [/SUP], Rahul D Pawar[SUP] 3 [/SUP], Katherine M Berg[SUP] 4 [/SUP], Shivani Mehta[SUP] 3 [/SUP], Parth V Patel[SUP] 3 [/SUP], Anne V Grossestreuer[SUP] 3 [/SUP]
Affiliations
- PMID: 33738759
- DOI: 10.1007/s11606-021-06647-2
Abstract
Background: Widespread reports suggest the characteristics and disease course of coronavirus disease 2019 (COVID-19) and influenza differ, yet detailed comparisons of their clinical manifestations are lacking.
Objective: Comparison of the epidemiology and clinical characteristics of COVID-19 patients during the pandemic with those of influenza patients in previous influenza seasons at the same hospital DESIGN: Admission rates, clinical measurements, and clinical outcomes from confirmed COVID-19 cases between March 1 and April 30, 2020, were compared with those from confirmed influenza cases in the previous five influenza seasons (8 months each) beginning September 1, 2014.
Setting: Large tertiary care teaching hospital in Boston, MA PARTICIPANTS: Laboratory-confirmed COVID-19 and influenza inpatients MEASUREMENTS: Patient demographics and medical history, mortality, incidence and duration of mechanical ventilation, incidences of vasopressor support and renal replacement therapy, and hospital and intensive care admissions.
Results: Data was abstracted from medical records of 1052 influenza patients and 582 COVID-19 patients. An average of 210 hospital admissions for influenza occurred per 8-month season compared to 582 COVID-19 admissions over 2 months. The median weekly number of COVID-19 patients requiring mechanical ventilation was 17 (IQR: 4, 34) compared to a weekly median of 1 (IQR: 0, 2) influenza patient (p=0.001). COVID-19 patients were significantly more likely to require mechanical ventilation (31% vs 8%) and had significantly higher mortality (20% vs. 3%; p<0.001 for all). Relatively more COVID-19 patients on mechanical ventilation lacked pre-existing conditions compared with mechanically ventilated influenza patients (25% vs 4%, p<0.001). Pneumonia/ARDS secondary to the virus was the predominant cause of mechanical ventilation in COVID-19 patients (94%) as opposed to influenza (56%).
Limitation: This is a single-center study which could limit generalization.
Conclusion: COVID-19 resulted in more weekly hospitalizations, higher morbidity, and higher mortality than influenza at the same hospital.
Keywords: COVID-19; influenza; mechanical ventilation.