Coronavirus disease 2019 (COVID-19) Versus Influenza in Hospitalized Adult Patients in the United States: Differences in Demographic and Severity Indicators

Talbot, H. Keipp; Martin, Emily T.; Gaglani, Manjusha; Middleton, Donald B.; Ghamande, Shekhar; Silveira, Fernanda P.; Murthy, Kempapura; Zimmerman, Richard K.; Trabue, Christopher; Olson, Samantha M; Petrie, Joshua G.; Ferdinands, Jill; Patel, Manish; Monto, Arnold S.; Smith, Emily; Bounds, Kelsey R; Calhoun, Nicole; Smith, Michael; Hawrylak, Andrew; Ladogana, Michael; Fernandez, Joseph; Elieson, Marc; Morrison, James H.; Midturi, John; McNeal, Tresa; Arroliga, Alejandro C.; Nowalk, Mary Patricia; Balasubramani, G.K.; Eng, Heather; Dauer, Klancie; Wyatt, Dayna; Zhu, Yuwei; Liu, Zhouwen; Longmire, Stephanie; Graves, Kellie; Sedillo, Emily; Simion, Alina; Speer, Karen; Alicie, Bethany; Krantz, Briana; Carillo, Donna; Adams, Laura; Drennan, A. M.; Orga, Jan; Peterson, Lynn M.; Halasa, Natasha; McHenry, Rendi; Pulido, Claudia Guevara; Lamerato, Lois; Malani, Anurag N.; Lauring, Adam S.; Malosh, Ryan E.

doi:10.1093/cid/ciab123

Cited by 23 publications

(38 citation statements)

References 30 publications

(21 reference statements)

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“…Our findings differ from a study in critically ill adults hospitalized with influenza or COVID-19 across 2 academic centers that reported COVID-19 to be associated with worse respiratory outcomes [ 23 ]. Another study of hospitalized adults [ 24 ] reported patients with COVID-19 to have fewer underlying conditions, increased need for ICU care and mechanical ventilation, and much higher mortality than those with influenza infection. Similar to that adult study, we showed that adolescents (aged 13–17 years) and preschoolers (aged 24–59 months) had longer hospital and ICU stays with COVID-19 than with influenza.…”

Section: Discussionmentioning

confidence: 99%

Life-Threatening Complications of Influenza vs Coronavirus Disease 2019 (COVID-19) in US Children

Spieker

Olson

Amarin

et al. 2022

Clinical Infectious Diseases

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Background Clinical differences between critical illness from influenza infection versus coronavirus disease 2019 (COVID-19) have not been well characterized in pediatric patients. Methods We compared U.S. children (8 months to 17 years) admitted to the intensive care or high acuity unit with influenza (17 hospitals, 12/19/2019–3/9/2020) or COVID-19 (52 hospitals, 3/15/2020–12/31/2020). We compared demographics, underlying conditions, clinical presentation, severity, and outcomes. Using mixed-effects models, we assessed the odds of death or requiring life-support for influenza versus COVID-19 after adjustment for age, sex, race and Hispanic origin, and underlying conditions including obesity. Results Children with influenza (n = 179) were younger than those with COVID-19 (n = 381; median 5.2 vs. 13.8 years), less likely to be non-Hispanic black (14.5% vs. 27.6%) or Hispanic (24.0% vs. 36.2%), and less likely to have ≥1 underlying condition (66.4% vs. 78.5%) or be obese (21.4% vs. 42.2%). They were similarly likely to require invasive mechanical ventilation (both 30.2%), vasopressor support (19.6% and 19.9%), or extracorporeal membrane oxygenation (2.2% and 2.9%). Four children with influenza (2.2%) and 11 children with COVID-19 (2.9%) died. The odds of death or requiring life-support in children with influenza vs. COVID-19 were similar (adjusted odds ratio, 1.30 [95% CI: 0.78–2.15; P = 0.32]). Median duration of hospital stay was shorter for influenza than COVID-19 (5 versus 7 days). Conclusions Despite differences in demographics and clinical characteristics of children with influenza or COVID-19, the frequency of life-threatening complications was similar. Our findings highlight the importance of implementing prevention measures to reduce transmission and disease severity of influenza and COVID-19.

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Section: Discussionmentioning

confidence: 99%

Life-Threatening Complications of Influenza vs Coronavirus Disease 2019 (COVID-19) in US Children

Spieker

Olson

Amarin

et al. 2022

Clinical Infectious Diseases

Self Cite

View full text Add to dashboard Cite

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“…Lastly, COVID-19 patients were found to have significantly worse outcomes than influenza patients: More often transferred to intensive care unit with a higher rate of mortality [13]. The severity of COVID-19 compared to influenza was demonstrated again in a study by Talbot et al, where patients with COVID-19 showed greater severity and complications, including more ICU admissions (aOR 5.3, 95% , ventilator use (aOR 15.6, 95% CI 10.7-22.8), seven additional days of hospital stay in those discharged alive, and death during hospitalization (aOR 19.8, 95% CI-12.0, 32.7) [14].…”

Section: Discussionmentioning

confidence: 86%

Comparison of clinical characteristics and outcomes of hospitalized patients with seasonal coronavirus infection and COVID-19: a retrospective cohort study

et al. 2022

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Background Unlike SARS-CoV and MERS-C0V, SARS-CoV-2 has the potential to become a recurrent seasonal infection; hence, it is essential to compare the clinical spectrum of COVID-19 to the existent endemic coronaviruses. We conducted a retrospective cohort study of hospitalized patients with seasonal coronavirus (sCoV) infection and COVID-19 to compare their clinical characteristics and outcomes. Methods A total of 190 patients hospitalized with any documented respiratory tract infection and a positive respiratory viral panel for sCoV from January 1, 2011, to March 31, 2020, were included. Those patients were compared with 190 hospitalized adult patients with molecularly confirmed symptomatic COVID-19 admitted from March 1, 2020, to May 25, 2020. Results Among 190 patients with sCoV infection, the Human Coronavirus-OC93 was the most common coronavirus with 47.4% of the cases. When comparing demographics and baseline characteristics, both groups were of similar age (sCoV: 74 years vs. COVID-19: 69 years) and presented similar proportions of two or more comorbidities (sCoV: 85.8% vs. COVID-19: 81.6%). More patients with COVID-19 presented with severe disease (78.4% vs. 67.9%), sepsis (36.3% vs. 20.5%), and developed ARDS (15.8% vs. 2.6%) compared to patients with sCoV infection. Patients with COVID-19 had an almost fourfold increased risk of in-hospital death than patients with sCoV infection (OR 3.86, CI 1.99–7.49; p < .001). Conclusion Hospitalized patients with COVID-19 had similar demographics and baseline characteristics to hospitalized patients with sCoV infection; however, patients with COVID-19 presented with higher disease severity, had a higher case-fatality rate, and increased risk of death than patients with sCoV. Clinical findings alone may not help confirm or exclude the diagnosis of COVID-19 during high acute respiratory illness seasons. The respiratory multiplex panel by PCR that includes SARS-CoV-2 in conjunction with local epidemiological data may be a valuable tool to assist clinicians with management decisions.

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“…Regarding the outcome, both infectious agents can lead to ARDS and death. Although affected by the timing and by the region (the quality of the care offered varies according to the phase of the pandemic, the “preparedness” of the health system and the economic level of the country), COVID-19 showed higher mortality or worse outcomes than Influenza in adulthood 26 , 28 , 31 – 33 …”

Section: Discussionmentioning

confidence: 99%

Comparison of the Clinical and Laboratory Features of Covid and Influenza in Children

Pata¹,

Buonsenso²,

Valentini³

2022

Mediterr J Hematol Infect Dis

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Background and Objectives. Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2 and has a clinical presentation ranging from asymptomatic course to flu-like syndrome up to respiratory failure. Seasonal Influenza, due by the influenza viruses and very common in children, can cause symptoms similar to COVID-19. In order to identify clinical and laboratory characteristics that allow health-care workers to differentiate COVID-19 from Influenza, we performed a systematic review of the existing literature in the pediatric age. Methods. The research was done via PubMed for articles published from March 2020 to October 2021, combining the MeSH words "COVID-19" and "Influenza" and "Children" and considering the suggestions of PRISMA Group. Results. The most frequently described symptoms were fever and cough in both groups. In most studies, high fever, cough, nasal congestion or rhinorrhea, vomiting and muscle pain were detected more frequently in the Influenza group. Regarding the value of laboratory tests, the results were mixed. Almost all studies reported significantly lower levels of C-reactive protein and procalcitonin in the COVID-19 group than in the Influenza group. In most manuscripts, COVID-19 had a milder course than Influenza. Conclusions. There are no symptoms characteristic of a single infectious agent, with flu-like disorders being the most common. In addition, laboratory tests do not help in the differential diagnosis but show a limited inflammatory response in COVID-19. This could explain the fewer complications compared to adulthood, with a less severe clinical course. Keywords: COVID-19; Influenza; children

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Coronavirus disease 2019 (COVID-19) Versus Influenza in Hospitalized Adult Patients in the United States: Differences in Demographic and Severity Indicators

Cited by 23 publications

References 30 publications

Life-Threatening Complications of Influenza vs Coronavirus Disease 2019 (COVID-19) in US Children

Life-Threatening Complications of Influenza vs Coronavirus Disease 2019 (COVID-19) in US Children

Comparison of clinical characteristics and outcomes of hospitalized patients with seasonal coronavirus infection and COVID-19: a retrospective cohort study

Comparison of the Clinical and Laboratory Features of Covid and Influenza in Children

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