학술논문
Comparison of Hospitalized Coronavirus Disease 2019 and Influenza Patients Requiring Supplemental Oxygen in a Cohort Study: Clinical Impact and Resource Consumption.
Document Type
Article
Author
Montesinos, Inmaculada López; Arrieta-Aldea, Itziar; Dicastillo, Aitor; Zuccarino, Flavio; Sorli, Luisa; Guerri-Fernández, Roberto; Arnau-Barrés, Isabel; Montero, Maria Milagro; Siverio-Parès, Ana; Durán, Xavier; Arenas, Maria del Mar; Arnau, Ariadna Brasé; Cañas-Ruano, Esperanza; Castañeda, Silvia; Kamber, Ignacio Domingo; Gómez-Junyent, Joan; Pelegrín, Iván; Martínez, Francisca Sánchez; Sendra, Elena; Leiro, Lucía Suaya
Source
Subject
*OBESITY
*HYPERTENSION
*COVID-19
*SAMPLE size (Statistics)
*CONFIDENCE intervals
*CHRONIC diseases
*TERTIARY care
*MEDICAL care costs
*IMMUNOSUPPRESSION
*MEDICAL care use
*TREATMENT effectiveness
*SEASONAL influenza
*OXYGEN therapy
*HOSPITAL care
*SYMPTOMS
*DESCRIPTIVE statistics
*DATA analysis software
*LONGITUDINAL method
*PROPORTIONAL hazards models
*COMORBIDITY
*ECONOMICS
MORTALITY risk factors
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Language
ISSN
1058-4838
Abstract
Background To compare clinical characteristics, outcomes, and resource consumption of patients with coronavirus disease 2019 (COVID-19) and seasonal influenza requiring supplemental oxygen. Methods Retrospective cohort study conducted at a tertiary-care hospital. Patients admitted because of seasonal influenza between 2017 and 2019, or with COVID-19 between March and May 2020 requiring supplemental oxygen were compared. Primary outcome: 30-day mortality. Secondary outcomes: 90-day mortality and hospitalization costs. Attempted sample size to detect an 11% difference in mortality was 187 patients per group. Results COVID-19 cases were younger (median years of age, 67; interquartile range [IQR] 54–78 vs 76 [IQR 64–83]; P <.001) and more frequently overweight, whereas influenza cases had more hypertension, immunosuppression, and chronic heart, respiratory, and renal disease. Compared with influenza, COVID-19 cases had more pneumonia (98% vs 60%, <.001), higher Modified Early Warning Score (MEWS) and CURB-65 (confusion, blood urea nitrogen, respiratory rate, systolic blood pressure, and age >65 years) scores and were more likely to show worse progression on the World Health Organization ordinal scale (33% vs 4%; P <.001). The 30-day mortality rate was higher for COVID-19 than for influenza: 15% vs 5% (P =.001). The median age of nonsurviving cases was 81 (IQR 74–88) and 77.5 (IQR 65–84) (P =.385), respectively. COVID-19 was independently associated with 30-day (hazard ratio [HR], 4.6; 95% confidence interval [CI], 2–10.4) and 90-day (HR, 5.2; 95% CI, 2.4–11.4) mortality. Sensitivity and subgroup analyses, including a subgroup considering only patients with pneumonia, did not show different trends. Regarding resource consumption, COVID-19 patients had longer hospital stays and higher critical care, pharmacy, and complementary test costs. Conclusions Although influenza patients were older and had more comorbidities, COVID-19 cases requiring supplemental oxygen on admission had worse clinical and economic outcomes. [ABSTRACT FROM AUTHOR]