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About twice as many patients were hospitalized in France for COVID-19 in a period of 2 months than they were hospitalized for seasonal flu in a period of 3 months in the previous year, according to a study published online in Respiratory Medicine Lancet.
Hospital mortality was almost three times higher for COVID-19 than for seasonal flu, the researchers found. In addition, patients with COVID-19 were more likely to require invasive mechanical ventilation (9.7% versus 4%) and had longer mean sessions (15 days versus 8 days).
“SARS-CoV-2 appears to have a higher potential for respiratory pathogenicity, leading to more respiratory complications in patients with fewer comorbidities and is associated with a higher risk of mortality, especially in adolescents, although any conclusions for this Age group should be treated with caution given the small number of deaths, “writes Lionel Piroth, MD, PhD, of the Department of Infectious Diseases, University Hospital Dijon, Dijon, France, and his colleagues.
The study “is the largest to date to compare the two diseases and confirms that COVID-19 is much more serious than the flu,” said study author Catherine Quantin, MD, PhD, in a press release. “The finding that the COVID-19 mortality rate was three times higher than in the case of seasonal influenza is particularly striking when we recall that the 2018/2019 flu season was the worst in the last five years in France in terms of the number of deaths, ”continued Quantin, who led the research together. It is affiliated to the University Hospital of Dijon and Inserm.
The investigators analyzed data from a national database and compared 89,530 hospitalizations in COVID-19 hospital between March 1 and April 30, 2020, with 45,819 seasonal influenza hospital admissions between December 1, 2018 and February 28, 2019.
The mortality rate was 16.9% among hospitalized patients with COVID-19, compared with 5.8% among hospitalized patients with influenza.
Fewer patients under the age of 18 were hospitalized with COVID-19 than with seasonal influenza (1.4% vs. 19.5%; 1227 vs. 8942), but a higher proportion of those younger than 5 years required therapy. intensive for COVID-19 (2.9% vs 0.9%). Mortality rates in children under 5 years of age were similar for both groups (0.5% vs. 0.2%).
Among patients aged 11 to 17 years, 5 of 548 (1.1%) patients with COVID-19 died, compared with 1 of 804 (0.1%) patients with influenza.
Influenza testing practices likely varied between hospitals, while testing for COVID-19 could have been more standardized. This could be a limitation of the study, the researchers note. In addition, flu seasons vary from year to year, and flu cases may depend on vaccination coverage and the residual immunity of the population.
“The large sample size is an important point of the study and it is assumed that the indication for hospitalization in the two periods was the same and therefore does not influence the results,” writes Eskild Petersen, MD, DMsc, in a comment that accompanies the study. The results … clearly show that COVID-19 is more serious than seasonal flu.
Moreover, this study and previous research show that “COVID-19 is not an innocent infection in children and adolescents,” said Petersen, who is affiliated with the University of Aarhus in Denmark and the European Society for Clinical Microbiology and Infectious Diseases. Force.
The study was funded by the French National Research Agency. Two authors have various financial links with several pharmaceutical companies, details of which are available in the journal article. Petersen did not disclose relevant financial statements.
Lancet Respir Med. Published online December 17, 2020. Abstract, Comment
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