A new nationwide French study comparing outcomes for patients in the intensive care unit (ICU) for either influenza or COVID-19 due to acute respiratory failure shows that COVID-19 patients had a longer hospital stay and a 69% higher mortality rate than ICU patients with influenza. The study was published yesterday in the Journal of Infection.
The study compared outcomes, including death and the need for mechanical ventilation, among COVID-19 patients hospitalized at any point from March 1, 2020, to June 30, 2021, and influenza patients seen from January 1, 2014, to December 31, 2019. A total of 105,979 COVID-19 patients were compared to 18,763 influenza patients.
The authors found patients with influenza seen in the ICU required more invasive mechanical ventilation (47% vs 34%), but patients with COVID-19 were 69% more likely to die during their hospital stay (25% vs 21% of patients; (adjusted hazard ratio, 1.69; 95% confidence interval, 1.63 to 1.75).
Critically ill COVID-19 patients were more likely to be men with comorbidities and were slightly younger than critically ill influenza patients. Thirty percent of COVID-19 patients seen in the ICU were under the age of 60.
"The type of comorbidities differed between the two populations," the authors explained. "Arterial hypertension [high blood pressure], diabetes mellitus, chronic kidney disease, and solid tumour were more frequent in COVID-19 patients, while congestive heart disease, chronic respiratory disease, cirrhosis, and malignancies were more frequent in influenza patients."
Only 5% of symptomatic COVID-19 patients required admission to the ICU for acute respiratory failure in this study, which is one of the largest studies focused on comparing COVID-19 with influenza patient outcomes in the ICU, the author said. But the 69% higher mortality rate persisted event after COVID-19 vaccines were widely available in early 2021.