InGef - Institute for applied healthcare research Berlin GmbH, Germany.
InGef - Institute for applied healthcare research Berlin GmbH, Germany.
Int J Infect Dis. 2021 Feb;103:316-322. doi: 10.1016/j.ijid.2020.11.204. Epub 2020 Dec 31.
Since the beginning of the severe acute respiratory syndrome coronavirus 2 pandemic, there is a discussion about the severity of coronavirus disease-2019 (COVID-19) in comparison to infections with seasonal Influenza. The objective of this study was to compare clinical and demographic characteristics of German patients hospitalized for infection with either SARS-CoV-2 or Influenza.
This study used anonymized German healthcare claims data. Patients with a confirmed COVID-19 or Influenza diagnosis, for whom a complete hospital course was available (i.e., the patient was discharged or died in hospital) were included. The data set included detailed information on patient characteristics and hospital treatment. Patients were grouped according to whether they were transferred to the intensive care unit (ICU), received mechanical ventilation (MV), or had a severe course of the disease (SD). Charlson Comorbidity Index in the eight quarters prior to hospitalization and secondary diagnoses during hospitalization were analyzed.
A total of 2343 hospitalized patients with COVID-19 and 6762 hospitalized patients with Influenza were included. Fifty-four percent of the patients were male patients, with men being twice as frequent in the COVID-19 severe groups. For both diseases, patients >49 years accounted for almost three-quarters of hospital cases and hypertension, diabetes mellitus, chronic kidney disease, and chronic obstructive pulmonary disease were the most common comorbidities. The proportion of cases with ICU, MV, and SD was substantially higher for patients with COVID-19 (ICU+: 21 vs. 13 %; MV+: 15 vs. 9%; and SD+: 28 vs. 16%). Overall inhospital mortality was more than two-fold higher in COVID-19 vs. Influenza (14 vs. 6%).). The length of ventilation and hospitalization, and the proportion of patients diagnosed with acute respiratory distress syndrome, systemic inflammatory response syndrome, or acute kidney injury were considerably higher in patients with COVID-19.
COVID-19 resulted in higher inhospital mortality and worse clinical outcomes than Influenza. This was not attributable to demographic characteristics, preexisting comorbidities, or patient triage, because the German healthcare system had not reached its limits in the pandemic. Discussions suggesting that COVID-19 and seasonal Influenza have similar severity cannot be based on clinical evidence.
自严重急性呼吸综合征冠状病毒 2 大流行开始以来，人们一直在讨论 2019 年冠状病毒病（COVID-19）与季节性流感感染相比的严重程度。本研究的目的是比较因 SARS-CoV-2 或流感感染而住院的德国患者的临床和人口统计学特征。
本研究使用了匿名的德国医疗保健索赔数据。纳入了确诊为 COVID-19 或流感且完整住院过程可用（即患者出院或死于医院）的患者。该数据集包含有关患者特征和医院治疗的详细信息。根据患者是否转入重症监护病房（ICU）、接受机械通气（MV）或出现严重疾病（SD），将患者分为不同的组。分析了住院前八个季度的 Charlson 合并症指数和住院期间的次要诊断。
共纳入 2343 例 COVID-19 住院患者和 6762 例流感住院患者。54%的患者为男性，COVID-19 严重组中男性是女性的两倍。对于这两种疾病，年龄>49 岁的患者占住院病例的近四分之三，高血压、糖尿病、慢性肾脏病和慢性阻塞性肺疾病是最常见的合并症。COVID-19 患者 ICU、MV 和 SD 的比例明显更高（ICU+：21%比 13%；MV+：15%比 9%；SD+：28%比 16%）。COVID-19 患者的院内死亡率比流感高两倍以上（14%比 6%）。总的来说，COVID-19 患者的通气和住院时间更长，急性呼吸窘迫综合征、全身炎症反应综合征或急性肾损伤的患者比例也更高。
与流感相比，COVID-19 导致更高的院内死亡率和更差的临床结局。这不是由于人口统计学特征、预先存在的合并症或患者分诊造成的，因为德国的医疗体系在大流行期间并未达到极限。认为 COVID-19 和季节性流感具有相似严重程度的讨论不能基于临床证据。
