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?:abstract
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OBJECTIVES: Since beginning of the SARS-CoV-2 pandemic, there is a discussion about the severity of COVID-19 in comparison to infections with seasonal Influenza. The objective of this study was to compare clinical and demographic characteristics of German patients hospitalized for infection with either SARS-CoV-2 or Influenza. METHODS: This study used anonymized German healthcare claims data. Patients with a confirmed COVID-19 or Influenza diagnosis, for whom a complete hospital course was available (i.e., the patient was discharged or died in hospital) were included. The data set included detailed information on patient characteristics and hospital treatment. Patients were grouped according to whether they were transferred to intensive care unit (ICU), received mechanical ventilation (MV) or had a severe course of the disease (SD). Charlson-Comorbidity-Index in the eight quarters prior to hospitalization and secondary diagnoses during hospitalization were analysed. RESULTS: A total of 2343 hospitalized COVID-19 patients and 6762 hospitalized Influenza patients were included. 54% of the patients were male, with men being twice as frequent in the COVID-19 severe groups. For both diseases, patients >49 years accounted for almost three-quarters of hospital cases and hypertension, diabetes mellitus, CKD and COPD were the most common comorbidities. The proportion of cases with ICU, MV and SD was substantially higher for COVID-19 patients (ICU+: 21 vs. 13 %; MV+: 15 vs. 9%; SD+: 28 vs. 16%). Overall in-hospital mortality was more than two-fold higher in COVID-19 vs. Influenza (14 vs. 6%).). Length of ventilation and hospitalization, and the proportion of patients diagnosed with ARDS, SIRS or acute kidney injury were considerably higher in COVID-19 patients. CONCLUSIONS: COVID-19 resulted in higher in-hospital mortality and worse clinical outcomes than Influenza. This was not attributable to demographic characteristics, pre-existing comorbidities or patient triage, since the German healthcare system had not reached its limits in the pandemic. Discussions suggesting that COVID-19 and seasonal Influenza have similar severity cannot be based on clinical evidence.
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