Mortality is 35% Higher for COVID-19 Hospitalized Patients Compared to Influenza Inpatients

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A new study demonstrates that for last year’s respiratory season, the difference in death rates were still much higher for COVID-19, but the gap closed significantly from the year before.

patient with pulse

Although there was an approximately a 35% higher risk of death in the COVID-19 cohort—even after accounting for other variables—the authors point out that this gap is closing.

In a new study published in JAMA, patients hospitalized with COVID-19 had a much higher mortality rate than those hospitalized with influenza in the fall-winter respiratory season of 2023-2024.

“Patients hospitalized for COVID-19 had a higher risk of death compared with those hospitalized for seasonal influenza (adjusted death rate, 5.70% vs 4.24% at 30 days; adjusted HR, 1.35 [95% CI, 1.10-1.66]),” the investigators wrote. Although this equates to approximately a 35% higher risk of death in the COVID-19 cohort—even after accounting for other variables—the authors point out that this gap is closing. They explain that during the seasonal virus season the year before (2022-2023), there was a 60% higher risk of death for hospitalized COVID-19 patients vs hospitalized influenza patients.

What You Need to Know

The study reveals that patients hospitalized with COVID-19 during the fall-winter 2023-2024 season had a significantly higher mortality rate compared to those hospitalized with seasonal influenza.

Despite the higher mortality rate for COVID-19 patients, the study highlights a positive trend—the gap in mortality rates between COVID-19 and influenza patients is narrowing.

The study utilized data from the US Department of Veterans Affairs electronic health databases and examined patients admitted to the hospital with COVID-19 or seasonal influenza between October 1, 2023, and March 27, 2024.

This is a significant drop in mortality, and the investigators point out there were no drastic differences associated with different variants. “There was no statistically significant difference in the risk of death among people hospitalized for COVID-19 before and during the JN1-predominant era (adjusted death rate, 5.46% vs 5.82% at 30 days; adjusted HR, 1.07 [95% CI, 0.89-1.28]).”

Study Parameters
The investigators utilized the US Department of Veterans Affairs electronic health databases from all 50 states.

The investigators examined patients who were admitted to the hospital with either a diagnosis of COVID-19 or seasonal influenza between October 1, 2023 - March 27, 2024. And within 2 days before and 10 days after a positive test result for SARS-CoV-2 or influenza.

They note that limitations for the study included that the population was predominantly older patients who were male, which does not a wider representation of the general population. Additionally, causes of death were not examined.

Clinical Implications
The investigators pointed out there are some variables including vaccine uptake and antiviral prescribing that can influence mortality and that the rates of hospitalization is nearly twice as much for COVID-19 patients compared to influenza patients in the most recent virus season.


Reference
Xie Y, Choi T, Al-Aly Z. Mortality in Patients Hospitalized for COVID-19 vs Influenza in Fall-Winter 2023-2024. JAMA. Published online May 15, 2024. doi:10.1001/jama.2024.7395
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