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. 2023 Aug;87(2):120-127.
doi: 10.1016/j.jinf.2023.05.011. Epub 2023 May 16.

Differences in clinical characteristics and outcomes between COVID-19 and influenza in critically ill adult patients: A national database study

Diane Naouri  1 , Tai Pham  2 , Martin Dres  3 , Albert Vuagnat  4 , Gaëtan Beduneau  5 , Alain Mercat  6 , Alain Combes  7 , Antoine Kimmoun  8 , Matthieu Schmidt  7 , Alexandre Demoule  3 , Matthieu Jamme  9
Affiliations

Differences in clinical characteristics and outcomes between COVID-19 and influenza in critically ill adult patients: A national database study

Diane Naouri et al. J Infect. 2023 Aug.

Abstract

Objective: Prior to the coronavirus disease 2019 (COVID-19) pandemic, influenza was the most frequent cause of viral respiratory pneumonia requiring intensive care unit (ICU) admission. Few studies have compared the characteristics and outcomes of critically ill patients with COVID-19 and influenza.

Methods: This was a French nationwide study comparing COVID-19 (March 1, 2020-June 30, 2021) and influenza patients (January 1, 2014-December 31, 2019) admitted to an ICU during pre-vaccination era. Primary outcome was in-hospital death. Secondary outcome was need for mechanical ventilation.

Results: 105,979 COVID-19 patients were compared to 18,763 influenza patients. Critically ill patients with COVID-19 were more likely to be men with more comorbidities. Patients with influenza required more invasive mechanical ventilation (47 vs. 34%, p < 0·001), vasopressors (40% vs. 27, p < 0·001) and renal-replacement therapy (22 vs. 7%, p < 0·001). Hospital mortality was 25% and 21% (p < 0·001) in patients with COVID-19 and influenza, respectively. In the subgroup of patients receiving invasive mechanical ventilation, ICU length of stay was significantly longer in patients with COVID-19 (18 [10-32] vs. 15 [8-26] days, p < 0·001). Adjusting for age, gender, comorbidities, and modified SAPS II score, in-hospital death was higher in COVID-19 patients (adjusted sub-distribution hazard ratio [aSHR]=1.69; 95%CI=1.63-1.75) compared with influenza patients. COVID-19 was also associated with less invasive mechanical ventilation (aSHR=0.87; 95%CI=0.85-0.89) and a higher likelihood of death without invasive mechanical ventilation (aSHR=2.40; 95%CI=2.24-2.57).

Conclusion: Despite younger age and lower SAPS II score, critically ill COVID-19 patients had a longer hospital stay and higher mortality than patients with influenza.

Keywords: COVID-19; Influenzae; Intensive care unit; Nationwide study.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
In-hospital mortality rate according to age and type of infection. Blue line represented COVID-19 patients. Orange line represents Influenzae patients. X-axis correspond to age. Y-axis correspond to in-hospital mortality rate.
See this image and copyright information in PMC

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References

    1. Aziz S., Arabi Y.M., Alhazzani W., Evans L., Citerio G., Fischkoff K., et al. Managing ICU surge during the COVID-19 crisis: rapid guidelines. Intensive Care Med. 2020;46(7):1303–1325. - PMC - PubMed
    1. Chen N., Zhou M., Dong X., Qu J., Gong F., Han Y., et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–513. - PMC - PubMed
    1. Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X., et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–1720. - PMC - PubMed
    1. Tallet F. (DREES/OSAM/LABSANTE/EXTERNES). Parcours hospitaliers des patients atteints de la Covid-19 de mars 2020 à janvier 2021; 2020.
    1. Deltour Q. (DREES/OSAM/LABSANTE). Parcours hospitaliers des patients atteints du Covid-19 lors des troisième et quatrième vagues épidémiques; 2021.