Mortality is higher in younger patients with coronavirus disease 2019 (COVID-19) compared with younger patients with influenza, according to study results published in The Lancet Respiratory Medicine.

The fatality rate of COVID-19 appears to be higher than in seasonal influenza; however, few studies have compared the respective burdens of the COVID-19 and influenza epidemics. Therefore, researchers in France conducted a nationwide retrospective cohort study to compare the population hospitalized for COVID-19 (from March 1-April 30, 2020) with the population hospitalized for influenza (from December 1, 2018-February 28, 2019) to assess their differences in risk factors, clinical characteristics, and outcomes.

A total of 89,530 patients with COVID-19 and 45,819 patients with influenza were identified during these respective study periods. The median age of patients was 68 years for COVID-19 and 71 years for influenza. Patients with COVID-19 were more frequently obese or overweight and more frequently had diabetes, hypertension, and dyslipidemia than patients with influenza, whereas those with influenza more frequently had heart failure, peripheral vascular disease, chronic respiratory disease, cirrhosis, and deficiency anemia.

Patients admitted to the hospital with COVID-19 more frequently developed acute respiratory failure, pulmonary embolism, septic shock, or hemorrhagic stroke than patients with influenza, but were less likely to develop myocardial infarction or atrial fibrillation. In-hospital mortality was higher in patients with COVID-19 than in patients with influenza (16.9% vs 5.8%).


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Of the patients hospitalized, the proportion of pediatric patients was smaller for COVID-19 than for influenza (1.4% vs 19.5%), but more patients younger than 5 years needed intensive care support for COVID-19 than for influenza (2.3% vs 0.9%). In adolescents, in-hospital mortality was 10 times higher for COVID-19 than for influenza, and the patients with COVID-19 were more frequently obese or overweight.

“These data are particularly relevant as the epidemic continues to grow around the world and several countries prepare for potential overlapping of the seasonal influenza and COVID-19 epidemics,” the study authors concluded.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Piroth L, Cottenet J, Mariet A-S, et al. Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study. Lancet Respir Med. Published online December 17, 2020. doi:10.1016/S2213-2600(20)30527-0