Hsu Wan-Hsuan, Shiau Bo-Wen, Tsai Ya-Wen, Wu Jheng-Yan, Liu Ting-Hui, Huang Po-Yu, Chuang Min-Hsiang, Lai Chih-Cheng
Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Center of Integrative Medicine, Chi Mei Medical Center, Tainan, Taiwan.
BMC Infect Dis. 2025 Mar 31;25(1):442. doi: 10.1186/s12879-025-10833-6.
The comparability of outcomes for non-hospitalized COVID-19 outpatients during the Omicron wave to outpatients with influenza remains uncertain. This study aims to compare the outcomes of non-hospitalized outpatients with COVID-19 and seasonal influenza during the fall-winter of 2022-2023.
This is a retrospective cohort study using TriNetX, a collaborative clinical research platform. Non-hospitalized outpatients with COVID-19 and seasonal influenza between 01 October 2022 and 31 January 2023 were selected from TriNetX. Propensity score matching (PSM) was used to compare patients receiving corresponding outpatient antiviral treatments. Hazard ratios (HRs) with 95% confidence intervals (CIs) for the primary outcome-a composite of all-cause emergency department (ED) visits, hospitalizations, or mortality during the 30-day follow-up period-were calculated and compared.
After PSM, two well-balanced groups of 9,030 patients each were identified. Non-hospitalized COVID-19 patients had a lower risk of primary composites outcomes including all-cause ED visits, hospitalization, or mortality (5.9% vs. 9.2%, HR, 0.661[95% CI, 0.593-0.737]) compared to the influenza group. In addition, the COVID-19 group demonstrated a reduced risk of all-cause ED visits (4.4% vs. 6.6%, HR 0.683[0.601-0.776]), hospitalization (1.7% vs. 2.9%, HR 0.605[0.495-0.739]) and mortality (0.1% vs. 0.2%, HR 0.176[0.052-0.597]), respectively.
This study indicates a lower risk of all-cause ED visits, hospitalization, and mortality in the non-hospitalized COVID-19 patients compared to the seasonal influenza group, supporting the current public health strategy of adjusting COVID-19 management based on approaches used for seasonal influenza.
在奥密克戎毒株流行期间，非住院的新冠门诊患者与流感门诊患者的预后可比性仍不确定。本研究旨在比较2022 - 2023年秋冬季节非住院的新冠门诊患者和季节性流感门诊患者的预后。
这是一项使用TriNetX（一个合作临床研究平台）的回顾性队列研究。从TriNetX中选取2022年10月1日至2023年1月31日期间非住院的新冠门诊患者和季节性流感门诊患者。采用倾向评分匹配（PSM）方法比较接受相应门诊抗病毒治疗的患者。计算并比较了主要结局（30天随访期内全因急诊就诊、住院或死亡的综合指标）的风险比（HR）及95%置信区间（CI）。
经过PSM，确定了两组各9030例均衡良好的患者。与流感组相比，非住院新冠患者出现包括全因急诊就诊、住院或死亡在内的主要综合结局的风险较低（5.9%对9.2%，HR为0.661[95%CI，0.593 - 0.737]）。此外，新冠组全因急诊就诊风险降低（4.4%对6.6%，HR 0.683[0.601 - 0.776]），住院风险降低（1.7%对2.9%，HR 0.605[0.495 - 0.739]），死亡风险降低（0.1%对0.2%，HR 0.176[0.052 - 0.597]）。
本研究表明，与季节性流感组相比，非住院新冠患者全因急诊就诊、住院和死亡的风险较低，支持当前基于季节性流感管理方法调整新冠管理的公共卫生策略。
