In-hospital outcomes of healthcare-associated COVID-19 (Omicron) versus healthcare-associated influenza: a retrospective, nationwide cohort study in Switzerland.

IF 8.2 1区医学 Q1 IMMUNOLOGY Clinical Infectious Diseases Pub Date : 2024-11-13 DOI:10.1093/cid/ciae558

Rebecca Grant, Marlieke E A de Kraker, Niccolò Buetti, Holly Jackson, Mohamed Abbas, Jonathan Aryeh Sobel, Rami Sommerstein, Marcus Eder, Carlo Balmelli, Nicolas Troillet, Peter W Schreiber, Philipp Jent, Laurence Senn, Domenica Flury, Sarah Tschudin-Sutter, Michael Buettcher, Maria Süveges, Laura Urbini, Olivia Keiser, Ursina Roder, Stephan Harbarth, Marie-Céline Zanella

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Abstract

Background: As COVID-19 is integrated into existing infectious disease control programs, it is important to understand the comparative clinical impact of COVID-19 and other respiratory diseases.

Methods: We conducted a retrospective cohort study of patients with symptomatic healthcare-associated COVID-19 or influenza reported to the nationwide, hospital-based surveillance system in Switzerland. Included patients were adults (≥18 years) hospitalized for ≥3 days in tertiary care and large regional hospitals. Patients had COVID-19 symptoms and a RT-PCR-confirmed SARS-CoV-2 infection ≥3 days after hospital admission between 1 February 2022 and 30 April 2023, or influenza symptoms and a RT-PCR-confirmed influenza A or B infection ≥3 days after hospital admission between 1 November 2018 and 30 April 2023. Primary and secondary outcomes were 30-day in-hospital mortality and admission to intensive care unit (ICU), respectively. Cox regression (Fine-Gray model) was used to account for time-dependency and competing events, with inverse probability weighting to adjust for confounding.

Results: We included 2901 patients with symptomatic healthcare-associated COVID-19 (Omicron) and 868 patients with symptomatic healthcare-associated influenza from nine hospitals. We found a similar case fatality ratio between healthcare-associated COVID-19 (Omicron) (6.2%) and healthcare-associated influenza (6.1%) patients; after adjustment, patients had a comparable subdistribution hazard ratio for 30-day in-hospital mortality (0.91, 95%CI 0.67-1.24). A similar proportion of patients were admitted to ICU (2.4% COVID-19; 2.6% influenza).

Conclusions: COVID-19 and influenza continue to cause severe disease among hospitalized patients. Our results suggest that in-hospital mortality risk of healthcare-associated COVID-19 (Omicron) and healthcare-associated influenza are comparable.

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医源性 COVID-19 (Omicron)与医源性流感的院内预后：瑞士全国范围内的回顾性队列研究。

背景：随着 COVID-19 被纳入现有的传染病控制计划，了解 COVID-19 与其他呼吸道疾病的临床影响比较就显得尤为重要：我们对向瑞士全国医院监测系统报告的有症状的医源性 COVID-19 或流感患者进行了一项回顾性队列研究。研究对象为在三级医院和大型地区医院住院≥3天的成人（≥18岁）。患者在2022年2月1日至2023年4月30日期间出现COVID-19症状且入院后RT-PCR确诊SARS-CoV-2感染≥3天，或在2018年11月1日至2023年4月30日期间出现流感症状且入院后RT-PCR确诊甲型或乙型流感感染≥3天。主要和次要结果分别为30天院内死亡率和入住重症监护室（ICU）。采用Cox回归（Fine-Gray模型）来考虑时间依赖性和竞争事件，并用逆概率加权来调整混杂因素：结果：我们纳入了九家医院的2901例有症状的医源性COVID-19（Omicron）患者和868例有症状的医源性流感患者。我们发现，医源性 COVID-19 (Omicron)（6.2%）和医源性流感（6.1%）患者的病死率相似；经调整后，患者的 30 天院内死亡率的亚分布危险比（0.91，95%CI 0.67-1.24）相当。入住重症监护室的患者比例相似（COVID-19为2.4%；流感为2.6%）：结论：COVID-19和流感继续在住院患者中引发严重疾病。我们的研究结果表明，医源性 COVID-19 (Omicron) 和医源性流感的院内死亡风险相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Infectious Diseases 医学-传染病学

CiteScore

25.00

自引率

2.50%

发文量

900

审稿时长

3 months

期刊介绍： Clinical Infectious Diseases (CID) is dedicated to publishing original research, reviews, guidelines, and perspectives with the potential to reshape clinical practice, providing clinicians with valuable insights for patient care. CID comprehensively addresses the clinical presentation, diagnosis, treatment, and prevention of a wide spectrum of infectious diseases. The journal places a high priority on the assessment of current and innovative treatments, microbiology, immunology, and policies, ensuring relevance to patient care in its commitment to advancing the field of infectious diseases.