Compared to patients with seasonal flu, COVID-19 patients are hospitalized against a greater need for ventilation and intensive care, longer hospital stays, more complications, and nearly five times the risk of death, according to a U.S. study that was published yesterday in BMJ.
The study, led by researchers from VA Saint Louis Health Care System, mined the U.S. Department of Veterans Affairs medical records database to compare the outcomes of 3,641 COVID-19 patients hospitalized from February 1 to June 17 with 12,676 hospitalizations with the flu from 2017 to 2019.
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Compared with influenza, COVID-19 was associated with a higher risk of death (risk ratio) [HR], 4.97), the need for mechanical ventilation (HR, 4.01) and intensive care (HR, 2.41), and the need for an additional 3 days in hospital.
Differences in mortality rates due to COVID-19 versus influenza were observed in people over 75 years of age with renal disease or depression and black patients with chronic kidney disease, chronic kidney disease. diabetes or obesity.
While both viruses affect the lungs, the study showed that COVID-19 can damage other organs. The novel coronavirus was also associated with an increased risk of severe renal injury (odds ratio) [OR], 1.52), a new need for dialysis (OR, 4.11) or insulin (OR, 1.86), severe septic shock (OR, 4.04), and the need for vasopressors to raise extremely low blood pressure (OR, 3.95).
Coauthor Ziyad Al-Aly, MD, of the VA Saint Louis Health Care System, said in a Washington University press release that one of the most surprising results of the study was the significant increase in risk of needing to initiate dialysis in COVID- 19 patients.
“These patients did not have diabetes until they received COVID-19,” he said. “Then their blood sugar was spinning, and they needed large doses of insulin. Is the diabetes reversed, or will long – term management be needed? Will it be Type 1 or Type 2 diabetes? We don’t know because COVID-19 has been scarce for a year. “
Long-term unknown problems
COVID-19 patients were also at increased risk for pulmonary embolism (OR, 1.50), deep vein thrombosis (OR, 1.50), stroke (OR, 1.62), acute inflammation of the heart muscle (OR, 7.82), ana heart rhythm and sudden cardiac death (OR, 1.76), elevated troponin levels (indicating heart attack or damage; OR, 1.75), rhabdomyolysis (rapid muscle breakdown; OR, 1.84), and elevated levels of aspartate aminotransferase (OR , 3.16) and alanine aminotransferase (NO, 2.65), both of which indicate liver damage.
“Among people admitted to hospital, compared with seasonal flu, COVID-19 was associated with an increased risk for extrapulmonary organ disorder, mortality, and increased use of health facilities,” wrote the the authors in the study. “The findings may inform the global conversation about the relative risks of COVID-19 and seasonal flu and may contribute to the ongoing effort to manage the global covid-19 pandemic.”
Noting coronavirus “long-haulers,” or coronavirus patients who have lingering symptoms long after recovering from their disease, Al-Aly said in the news that no-one knows what the long-term problems are. COVID-19 will be long overdue.
“Even for people who are fortunate enough to survive a severe COVID-19 illness, they may forever be overwhelmed by the lasting impact of its long-term clinical complications,” he said. . “The more we understand, the better we can measure health care facilities and treat patients.”