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According to a study published online in, approximately twice as many patients admitted to hospitals in France for COVID-19 over a period of 2 months than those admitted for seasonal flu for a period of 3 months the previous year Respiratory Medicine Lancet.
The researchers found that hospital mortality was almost three times higher for COVID-19 than for seasonal flu. In addition, patients with COVID-19 were more likely to require invasive mechanical ventilation (9.7% vs. 4%) and had a longer mean stay (15 days vs. 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 an increased risk of mortality, especially in adolescents, although any findings need to be considered. for this age group. be treated with caution given the small number of deaths, “writes Lionel Piroth, MD, PhD, of the Department of Infectious Diseases at the University Hospital of Dijon, Dijon, France, and col. leagues.
The study “is the largest to date to compare the two diseases and confirms that COVID-19 is much more severe than influenza,” said study author Catherine Quantin, MD, PhD, in a press release. “The finding that the mortality rate for COVID-19 was three times higher than that of seasonal flu is particularly surprising when one remembers that the 2018/2019 flu season had been the worst in the last five years in France in terms of number of deaths, “continued Quantin, who jointly led the investigation. It is affiliated to the University Hospital of Dijon and Inserm.
The researchers analyzed data from a national database and compared 89,530 COVID-19 hospital admissions between March 1 and April 30, 2020, with 45,819 seasonal flu hospital admissions between December 1. of 2018 and February 28, 2019.
The mortality rate was 16.9% among hospitalized patients with COVID-19, compared with 5.8% of 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 larger proportion of those under the age of 5 required intensive care for COVID-19. 19 (2.9% vs. 0.9%). Mortality rates in children under 5 years of age were similar for the two 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 probably varied by hospital, while COVID-19 testing may have been more standardized. The researchers point out that this could be a limitation of the study. In addition, flu seasons vary from year to year and flu cases may depend on vaccination coverage and residual immunity in the population.
“The large sample size is an important strength of the study and it is assumed that the indication for hospital admission in the two periods was the same and therefore does not skew the results,” writes Eskild Petersen, MD, DMsc , in a commentary accompanying the study. “The results … clearly show that COVID-19 is more severe than seasonal flu.”
In addition, this study and previous research show that “COVID-19 is not an innocent infection in children and adolescents,” said Petersen, who is affiliated with Aarhus University in Denmark and the European Society of Clinical Microbiology and Infectious Diseases. . Strength.
The study was funded by the French National Research Agency. Two authors have various financial links with various pharmaceutical companies, details of which are available in the journal article. Petersen has not disclosed any relevant financial relationship.
Lancet Respir Med. Posted online December 17, 2020. Summary, Comment
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