COVID-19 Confirmed More Costly and Fatal than Influenza

According to a recent retrospective cohort study conducted at the Hospital del Mar in Barcelona, Spain, when adults were hospitalized with COVID-19, they were at a greater risk of death than those with influenza.

After accounting for potential confounders, including age, comorbidities, sex, disease severity, pneumonia, and corticosteroid treatment, these researchers found that COVID-19 patients were more than three times as likely to die after being admitted to hospital than influenza patients.

The findings announced on April 21, 2022, also suggest that COVID-19 is associated with more extended stays in intensive care and costs nearly twice as much to treat.

The analysis presented at the European Congress of Clinical Microbiology & Infectious Diseases (oral abstract  #1939) found that COVID-19 was associated with a higher risk of infection severity and admission to ICU (26 [14%] influenza vs. 69 [39%] ) for COVID-19. 

Further analyses showed that COVID-19 patients spent far longer in hospital (14 days vs. 11 days) and ICU (17 vs. 10 days) compared with influenza patients. 

Moreover, the average cost of critical care for COVID-19 patients was almost twice as much as for influenza patients (€21,350 vs. €12,082). 

And pharmacy treatment and testing costs were also significantly higher in the COVID-19 study group.

Overall, 29/187 (15%) COVID-19 patients and 10/187 (5%) influenza patients died of any cause within 30-days of hospitalization, and the death rate after 90 days was even higher (19%; 35/187 vs. 6%; 12/187). 

The authors noted no differences in mortality trends between the three seasonal influenza periods studied.

“Our findings suggest COVID-19 is far more lethal than influenza”, says lead author Dr. Inmaculada Lopez Montesinos from the Hospital del Mar in Barcelona, Spain, in a related press release.

“Despite influenza patients being older and having more comorbid illnesses, COVID-19 patients had consistently worse health outcomes and were considerably more expensive to treat.” 

“Even for those people who are lucky enough to survive COVID-19 and make it out of the hospital, they will be forever scarred by the consequences.” 

“It is vital that people get fully vaccinated and boosted against both viruses.”

"I have often commented to colleagues over the past two years that I look forward to the “story” that all of the data collected during the pandemic will tell us when analyzed", Chris Felton, PharmD, Brookshire Grocery Company shared.

"What did we get right, and what did we get wrong?  It will be essential to remember to look at the context, though."

"This study looks back at data from hospitalized patients in the early days of the pandemic.  There was no vaccine available or treatment consensus for critically ill Covid-19 patients." 

"I suspect that a glimpse at global numbers across the span of the pandemic will confirm the increased mortality risk of Covid-19 versus influenza among hospitalized patients, but it will be interesting to see," concluded Felton.

On April 18, 2022, the World Health Organization (WHO) issued a statement: With the increasing detections of influenza during the COVID-19 pandemic, countries are recommended to prepare for co-circulation of influenza and SARS-CoV-2 viruses. 

And clinicians should consider influenza in differential diagnosis, especially for high-risk groups for influenza, and test and treat according to national guidance.

The WHO, the U.S. CDC, and U.S. FDA recently confirmed that simultaneously administering these vaccines has advantages and is encouraged.

On Feb. 17, 2022, the CDC published updated influenza vaccine schedules for children and adults for 2022. 

The study authors acknowledge several limitations of their study, but no relevant industry conflicts of interest. These researchers examined medical records of 187 patients (average age 76 years, 55% male) admitted to the hospital with seasonal influenza infection between 2017 and 2019 and 187 COVID-19 patients (average age 67 years, 49% male) hospitalized during the first wave of the pandemic between March and May 2020, who all required oxygen therapy at admission.

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