Patients hospitalized with health care-associated COVID-19 and those with health care-associated influenza have similar rates of 30-day in-hospital mortality and intensive care unit (ICU) admission, according to study results published in Clinical Infectious Diseases.
Researchers conducted a retrospective cohort study to compare clinical outcomes between adult inpatients who acquired either health care-associated COVID-19 (Omicron) or health care-associated influenza (A or B) during hospitalization. All study patients were symptomatic and tested positive for infection via reverse transcription polymerase chain reaction at least 3 days following hospital admission. The primary outcome was 30-day in-hospital mortality, and the secondary outcome was 30-day ICU admission. The researchers used Cox regression models to control for time-dependency and competing events and inverse probability weighting to adjust for confounding.
Among patients in the COVID-19 (n=2901) and influenza (n=868) cohorts, the median ages were 79 (IQR, 68-86) and 76 (IQR, 63-85) years, 53% and 50% were women, and 95% and 86% had comorbidities of any type, respectively. Compared with those in the influenza cohort, patients with COVID-19 were more likely to have hypertension (63% vs 57%; P <.01) but exhibited significantly lower rates of chronic liver disease (6% vs 10%; P <.01) and chronic neurologic impairment (18% vs 23%; P <.01).
Of patients in the COVID-19 and influenza cohorts, the median time from hospital admission to laboratory-confirmed infection was 13 (IQR, 7-24) and 11 (IQR, 6-22) days, respectively. Stratified by vaccination status, the length of hospitalization for patients in the COVID-19 cohort was longer among those who were unvaccinated (median, 16 [IQR, 8-30] days) vs vaccinated (median, 14 [IQR, 7-30] days). Patients with influenza exhibited the shortest length of hospitalization overall (median, 11 [IQR, 6-28] days).
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Our findings support infection prevention and control measures, as well as hospital policies, moving away from the specific and extensive COVID-19 measures, and considering measures for respiratory viruses, more broadly.
Further analysis of patients in the COVID-19 and influenza cohorts indicated similar rates of 30-day in-hospital mortality (6.2% and 6.1%, respectively) and ICU admission (2.4% and 2.6%, respectively). However, patients who acquired influenza during hospitalization experienced more complications overall (35.5% vs 29.3%).
In the adjusted analysis, there was no significant between-group difference in the risk of in-hospital mortality (subdistribution hazard ratio, [sHR], 0.94; 95% CI, 0.69-1.28; P =0.70). There were also no significant between-group differences in hospital discharge (SHR, 1.04; 95% CI, 0.93-1.11; P =.80) or in-hospital mortality with discharge as a competing risk (sHR, 0.91; 95% CI, 0.67-1.24; P =.054).
Limitations of this study include the absence of asymptomatic patients, the inability to differentiate patients with influenza by vaccination status, and the lack of data regarding the impact of prior infection on in-hospital outcomes.
According to the researchers, “Our findings support infection prevention and control measures, as well as hospital policies, moving away from the specific and extensive COVID-19 measures, and considering measures for respiratory viruses, more broadly.”
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
This article originally appeared on Infectious Disease Advisor
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