Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium.
Epidemiology and Biostatistics Unit, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium.
J Infect Chemother. 2022 Nov;28(11):1489-1493. doi: 10.1016/j.jiac.2022.07.012. Epub 2022 Aug 6.
The COVID-19 pandemic has emerged as a global health problem, associated with high morbidity and mortality rates. The aim of this study was to compare the outcomes of hospitalized patients with COVID-19 or with seasonal influenza in a teaching hospital in Belgium.
In this retrospective, single-center cohort study, 1384 patients with COVID-19 and 226 patients with influenza were matched using a propensity score with a ratio of 3:1. Primary outcomes included admission to intensive care unit (ICU), intubation rates, hospital length of stay, readmissions within 30 days and in-hospital mortality. Secondary outcomes included pulmonary bacterial superinfection, cardiovascular complications and ECMO.
Based on the analysis of the matched sample, patients with influenza had an increased risk of readmission within 30 days (Risk Difference (RD): 0.07, 95% CI: 0.03 to 0.11) and admission to intensive care unit (RD: 0.09, 95% CI: 0.03 to 0.15) compared with those with COVID-19. Patients with influenza had also more pulmonary bacterial superinfections (46.2% vs 7.4%) and more cardiovascular complications (32% vs 3.9%) than patients with COVID-19.However, a two-fold increased risk of mortality (RD: -0.10, 95% CI: 0.15 to -0.05) was observed in COVID-19 compared to influenza. ECMO was also more required among the COVID-19 patients who died than among influenza patients (5% vs 0%).
COVID-19 is associated with a higher in-hospital mortality compared to influenza infection, despite a high rate of ICU admission in the influenza group. These findings highlighted that the severity of hospitalized patients with influenza should not be underestimated.
COVID-19 大流行已成为全球健康问题，与高发病率和死亡率相关。本研究旨在比较在比利时一家教学医院住院的 COVID-19 患者和季节性流感患者的结局。
在这项回顾性、单中心队列研究中，使用倾向评分匹配了 1384 例 COVID-19 患者和 226 例流感患者，匹配比例为 3:1。主要结局包括入住重症监护病房（ICU）、插管率、住院时间、30 天内再入院和院内死亡率。次要结局包括肺部细菌合并感染、心血管并发症和体外膜肺氧合（ECMO）。
基于匹配样本的分析，与 COVID-19 患者相比，流感患者 30 天内再入院的风险增加（风险差异（RD）：0.07，95%CI：0.03 至 0.11）和入住 ICU 的风险增加（RD：0.09，95%CI：0.03 至 0.15）。流感患者也比 COVID-19 患者更容易发生肺部细菌合并感染（46.2%比 7.4%）和心血管并发症（32%比 3.9%）。然而，COVID-19 患者的死亡率增加了两倍（RD：-0.10，95%CI：0.15 至 -0.05），与流感相比。COVID-19 患者死亡比流感患者更需要 ECMO（5%比 0%）。
与流感感染相比，COVID-19 患者的院内死亡率更高，尽管流感组 ICU 入住率较高。这些发现强调了不应低估住院流感患者的严重程度。
