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Comparison Between Influenza and COVID-19 at a Tertiary Care Center

By Michael W Donnino, Ari Moskowitz, Garrett S. Thompson, Stanley J. Heydrick, Rahul D Pawar, Kate M Berg, Shivani Mehta, Parth V Patel, Anne v Grossestreuer

Posted 22 Aug 2020
medRxiv DOI: 10.1101/2020.08.19.20163857

ABSTRACT Background: Widespread reports suggest the characteristics and disease course of coronavirus disease 2019 (COVID-19) and influenza differ, yet detailed comparisons of their clinical manifestations are lacking. Objective: Comparison of the epidemiology and clinical characteristics of COVID-19 patients with those of influenza patients in previous seasons at the same hospital Design: Admission rates, clinical measurements, and clinical outcomes from confirmed COVID-19 cases between March 1 and April 30, 2020 were compared with those from confirmed influenza cases in the previous five influenza seasons (8 months each) beginning September 1, 2014. Setting: Large tertiary care teaching hospital in Boston, Massachusetts Participants: Laboratory-confirmed COVID-19 and influenza inpatients Measurements: Patient demographics and medical history, mortality, incidence and duration of mechanical ventilation, incidences of vasopressor support and renal replacement therapy, hospital and intensive care admissions. Results: Data was abstracted from medical records of 1052 influenza patients and 583 COVID-19 patients. An average of 210 hospital admissions for influenza occurred per 8-month season compared to 583 COVID-19 admissions over two months. The median weekly number of COVID-19 patients requiring mechanical ventilation was 17 (IQR: 4, 34) compared to a weekly median of 1 (IQR: 0, 2) influenza patient (p=0.001). COVID-19 patients were significantly more likely to require mechanical ventilation (31% vs 8%), and had significantly higher mortality (20% vs. 3%; p<0.001 for all). Relatively more COVID-19 patients on mechanical ventilation lacked pre-existing conditions compared with mechanically ventilated influenza patients (25% vs 4%, p<0.001). Limitation: This is a single-center study which could limit generalization. Conclusion: COVID-19 resulted in more hospitalizations, higher morbidity, and higher mortality than influenza at the same hospital.

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