Research Shows Substantially Higher Burden of COVID-19 Compared to Flu

Research conducted at BIDMC is one of the first to compare the impact of COVID-19 on patients and hospital resources with the impact of influenza.

In a paper published in the Journal of General Internal Medicine, physician researchers at Beth Israel Deaconess Medical Center (BIDMC) assessed the relative impact of COVID-19 on patients admitted with the viral infection in March and April 2020, compared to patients who had been hospitalized with the flu. during the last five flu seasons at the medical center. Overall, the team showed that COVID-19 cases resulted in significantly more weekly hospitalizations, more use of mechanical ventilation, and higher death rates than influenza.

COVID-19 and influenza are both contagious respiratory viral diseases that, in severe cases, can lead to pneumonia and acute respiratory failure. However, a detailed comparison of the epidemiology and clinical features of COVID-19 and that of influenza is lacking.

“COVID-19 has been compared to influenza by both healthcare providers and lay people, but there is really limited detailed objective data available to compare and contrast the impact of these two diseases on patients and hospitals,” said corresponding author Michael Donnino, MD , Critical Care and Emergency Medicine arts at BIDMC. “We compared patients who had been admitted to BIDMC with COVID-19 in the spring of 2020 with patients who had been admitted to BIDMC with influenza during the last five influenza seasons. We found that COVID-19 causes a more serious illness and is more deadly than flu. “

Donnino and colleagues enrolled a total of 1,634 hospitalized patients in their study, 582 of whom had laboratory-confirmed COVID-19 and 1052 of whom had confirmed influenza. The team found that an average of 210 patients were admitted to BIDMC during each eight-month flu season, compared to the 582 patients with COVID-19 admitted in March and April 2020. While 174 patients with COVID-19 (or 30 percent) received mechanical ventilation during the two-month period, only 84 patients with influenza (or 8 percent) received ventilation during all five seasons of influenza. Likewise, the percentage of patients who died was much higher for COVID-19 than for influenza; 20 percent of the patients admitted with COVID-19 died in the two-month period, compared with three percent of the patients with the flu for five seasons.

Further analysis found that hospitalized patients with COVID-19 were generally younger than those hospitalized with the flu. Of the patients who required mechanical ventilation, patients on COVID-19 received much longer ventilation – a median duration of two weeks – compared to just over three days for patients with the flu. In addition, patients with COVID-19 in patients requiring mechanical ventilation were much less likely to have pre-existing medical conditions.

“Our data illustrates that 98 percent of deaths of patients hospitalized with COVID-19 were directly or indirectly related to their COVID-19 disease, illustrating that patients did not die from COVID but rather from COVID pneumonia. or a complication, ”said Donnino.

The authors note that the strict social distance guidelines in effect last spring may have affected these findings by limiting the incidence and lethality of COVID-19 by the end of April 2020. Conversely, some treatment practices have evolved over the course of the pandemic, potentially improving outcomes for patients with COVID-19.

Reference: “Comparison between hospitalized patients with influenza and COVID-19 in a tertiary care facility” by Michael W. Donnino MD, Ari Moskowitz MD, Garrett S. Thompson MPH, Stanley J. Heydrick PhD, Rahul D Pawar MD, Katherine M Berg MD, Shivani Mehta BA, Parth V. Patel BSN, RN and Anne V. Grossestreuer PhD, March 18, 2021, Journal of General Internal Medicine.
DOI: 10.1007 / s11606-021-06647-2

Co-authors included Ari Moskowitz, MD, Garrett S. Thompson, MPH, Stanley J. Heydrick, PhD, Rahul D. Pawar, MD, Katherine M. Berg, MD, Shivani Mehta, Parth V. Patel, BSN, RN and Anne V. Grossestreuer, PhD, all of Beth Israel Deaconess Medical Center.

This work was supported by internal funding. Donnino, Moskowitz, and Berg are supported in part by grants from the National Institutes of Health (K24HL127101, R01HL136705, and 1R01DK112886; K23GM128005; and K23HL128881404).