This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features!
Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

NIH NLM Logo
Log in
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec 16;73(12):2240-2247.
doi: 10.1093/cid/ciab123.

Coronavirus disease 2019 (COVID-19) Versus Influenza in Hospitalized Adult Patients in the United States: Differences in Demographic and Severity Indicators

Collaborators, Affiliations

Coronavirus disease 2019 (COVID-19) Versus Influenza in Hospitalized Adult Patients in the United States: Differences in Demographic and Severity Indicators

H Keipp Talbot et al. Clin Infect Dis. .

Abstract

Background: Novel coronavirus disease 2019 (COVID-19) is frequently compared with influenza. The Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN) conducts studies on the etiology and characteristics of U.S. hospitalized adults with influenza. It began enrolling patients with COVID-19 hospitalizations in March 2020. Patients with influenza were compared with those with COVID-19 in the first months of the U.S. epidemic.

Methods: Adults aged ≥ 18 years admitted to hospitals in 4 sites with acute respiratory illness were tested by real-time reverse transcription polymerase chain reaction for influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing COVID-19. Demographic and illness characteristics were collected for influenza illnesses during 3 seasons 2016-2019. Similar data were collected on COVID-19 cases admitted before June 19, 2020.

Results: Age groups hospitalized with COVID-19 (n = 914) were similar to those admitted with influenza (n = 1937); 80% of patients with influenza and 75% of patients with COVID-19 were aged ≥50 years. Deaths from COVID-19 that occurred in younger patients were less often related to underlying conditions. White non-Hispanic persons were overrepresented in influenza (64%) compared with COVID-19 hospitalizations (37%). Greater severity and complications occurred with COVID-19 including more ICU admissions (AOR = 15.3 [95% CI: 11.6, 20.3]), ventilator use (AOR = 15.6 [95% CI: 10.7, 22.8]), 7 additional days of hospital stay in those discharged alive, and death during hospitalization (AOR = 19.8 [95% CI: 12.0, 32.7]).

Conclusions: While COVID-19 can cause a respiratory illness like influenza, it is associated with significantly greater severity of illness, longer hospital stays, and higher in-hospital deaths.

Keywords: COVID-19; ICU admissions; hospitalization; influenza; race/ethnicity.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Patients hospitalized with influenzaa or COVID-19b, HAIVEN, 2016–2020. HAIVEN: Hospital Adult Influenza Vaccine Effectiveness Network. aThe case definition for influenza included patients ≥18 years, with a qualifying acute respiratory syndrome (new or worsening cough or sputum production with onset within previous 10 days), onset of illness prior to hospitalization, and clinical and/or respiratory specimen collection for laboratory analysis within 10 days of illness onset and within 72 hours of hospital admission. bThe case definition for COVID-19 included patients ≥18 years, confirmed RT-PCR testing for SARS-CoV-2 RNA from respiratory specimens, onset of illness prior to hospitalization, and reporting symptoms of cough or change in amount or appearance of sputum/phlegm/mucus.
Figure 2.
Figure 2.
Symptoms of patients hospitalized with influenzaa (n = 1937) compared with patients hospitalized with COVID-19b (n = 914), HAIVEN, 2016–2020. HAIVEN: Hospital Adult Influenza Vaccine Effectiveness Network. a.Information on the following symptoms were missing from influenza patients: 1 (0.1%) extreme tiredness/ fatigue, 3 (0.2%) shortness of breath, 1 (0.1%) runny nose/ congestion, 2 (0.1%) fever/feverish, 2 (0.1%) sputum/phlegm/mucus, 1 (0.1%) wheezing, 4 (0.2%) body aches, 3 (0.2%) headache, 3 (0.2%) sore throat, and 1 (0.1%) confusion. bInformation on the following symptoms were missing from COVID-19 patients: 73 (8%) extreme tiredness/ fatigue, 7 (1%) shortness of breath, 94 (10%) runny nose/congestion, 8 (1%) fever/feverish, 88 (10%) sputum/phlegm/mucus, 114 (12%) wheezing, 61 (7%) body aches, 79 (9%) headache, 98 (11%) sore throat, and 93 (10%) confusion.
Figure 3.
Figure 3.
Duration of hospitalization for patients hospitalized with influenza compared with patients hospitalized with COVID-19 in days (mean) by agea, HAIVEN, 2016-2020. HAIVEN: Hospital Adult Influenza Vaccine Effectiveness Network. aThis analysis was restricted to patients discharged alive. Length of stay was longer for COVID-19 patients compared to influenza patients with an increase of 7.7 days (95% CI: 6.9, 8.4, P < .01).
Figure 4.
Figure 4.
Percentage of inpatient hospital deaths in patients hospitalized with influenzaa compared with patients hospitalized with COVID-19b by age, HAIVEN, 2016-2020. HAIVEN: Hospital Adult Influenza Vaccine Effectiveness Network. a18 (0.9%) Influenza patients missing discharge status. b17 (1.9%) COVID-19 patients missing age or discharge status.

References

    1. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382:1708–20. - PMC - PubMed
    1. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395:497–506. - PMC - PubMed
    1. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323: 1061–9. - PMC - PubMed
    1. Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579:270–3. - PMC - PubMed
    1. Livingston E, Bucher K, Rekito A. Coronavirus disease 2019 and Influenza 2019–2020. JAMA 2020; 323:1122. - PubMed

Publication types

Cite

AltStyle によって変換されたページ (->オリジナル) /