Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Department of Medicine, Division of Pulmonary Critical Care, Beth Israel Deaconess Medical Center, Boston, MA, USA.
J Gen Intern Med. 2021 Jun;36(6):1689-1695. doi: 10.1007/s11606-021-06647-2. Epub 2021 Mar 18.
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.
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.
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.
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%).
This is a single-center study which could limit generalization.
COVID-19 resulted in more weekly hospitalizations, higher morbidity, and higher mortality than influenza at the same hospital.
广泛的报道表明，2019 年冠状病毒病（COVID-19）和流感的特征和疾病过程不同，但缺乏对其临床表现的详细比较。
比较大流行期间 COVID-19 患者的流行病学和临床特征与同一医院以往流感季节流感患者的特征。
比较 2020 年 3 月 1 日至 4 月 30 日期间确诊的 COVID-19 病例的入院率、临床测量值和临床结局与 2014 年 9 月 1 日开始的前五个流感季节（每个季节 8 个月）确诊的流感病例。
马萨诸塞州波士顿的一家大型三级保健教学医院。
实验室确诊的 COVID-19 和流感住院患者。
患者人口统计学和病史、死亡率、机械通气的发生率和持续时间、血管加压支持和肾脏替代治疗的发生率以及住院和重症监护病房的入院率。
从 1052 例流感患者和 582 例 COVID-19 患者的病历中提取数据。每个 8 个月的流感季节平均有 210 例住院治疗，而在 2 个月内有 582 例 COVID-19 住院治疗。每周需要机械通气的 COVID-19 患者中位数为 17（IQR：4，34），而每周中位数为 1（IQR：0，2）流感患者（p=0.001）。COVID-19 患者需要机械通气的可能性明显更高（31%对 8%），死亡率明显更高（20%对 3%；所有 p<0.001）。与机械通气的流感患者相比，需要机械通气的 COVID-19 患者相对较少有基础疾病（25%对 4%，p<0.001）。COVID-19 患者机械通气的主要原因是病毒引起的肺炎/ARDS（94%），而流感患者则是（56%）。
这是一项单中心研究，可能会限制推广。
同一医院 COVID-19 的每周住院人数、发病率和死亡率均高于流感。
