Yes, COVID is still deadlier than the flu

Findings from the Veterans Administration (VA) database show that hospitalizations due to COVID-19 during the latest flu season remained significantly more lethal than those due to influenza, although the difference was early in the pandemic. It seems to have shrunk significantly from .

A study of more than 11,000 hospitalizations for either of the two infectious diseases this fall and winter found that 5.97% of COVID-19 patients died within 30 days of hospitalization, compared with 3.75% of influenza patients. He died, said Ziyad Al-Aly, MD of the VA. His system and his colleagues at St. Louis Health Care in Missouri.

In a propensity score agreement analysis that accounts for age, gender, previous infections, and many other factors, this difference led to a 61% higher risk of death in the COVID group (HR 1.61, 95% CI 1.29 -2.02). , the authors detailed in a research letter published in jam.

Additionally, COVID-19 accounted for the majority of hospitalizations during the study period (2,403 vs. 8,996 for influenza) and caused more than seven times as many patient deaths (538 vs. 76).

“However, the difference between COVID-19 and influenza mortality appears to have decreased since the early days of the pandemic,” said Al-Aly and co-authors.

In-hospital COVID patient mortality in 2020 was 17% To twenty one% In some studies, the rate is about three times higher than the 6% rate in current studies, the authors note. For hospitalizations for influenza, the mortality rate was about the same (3.8% for him in 2020).

“Reduced mortality among people hospitalized with COVID-19 may be due to altered SARS-CoV-2 variants, increased levels of immunity (from vaccination and previous infections), and improved clinical care.” suggested the group.

All other groups had higher post-COVID mortality, except for individuals aged 65 years and younger, who had similar 30-day mortality rates for COVID and influenza patients (1.29% vs. 1.33%).

The increased risk of death from influenza was greatest among unvaccinated individuals for COVID (8.75% vs 3.86%; HR 2.32, 95% CI 1.80-3.00), with risk increasing with number of COVID-19 vaccinations. has decreased significantly. The importance of vaccination in reducing the risk of death from COVID-19,” he writes Al-Aly et al.

Also, COVID patients had a higher risk of death than influenza if they were over 65 years of age or did not receive outpatient treatment such as nirmatrelvir-ritonavir (Paxlobid), molnupiravir (Lagebrio), and remdesivir (Veklury).

For the study, Al-Aly’s team used the VA’s electronic health database, with a hospitalized diagnosis of COVID-19 or influenza between October 2022 and January 2023, and two or up to 10 days prior to hospitalization. We enrolled all individuals who tested positive. after admission. Co-infected persons were excluded.

After propensity weighting, the mean age of patients was 73 years, 71% were Caucasian, 23% were Black, and 95% were male. The mean body mass index was 28 and the mean estimated glomerular filtration rate was 64–65. About 1 in 5 of her had previously had her COVID, and about 63% were current or former smokers.

In terms of vaccination history, just under two-thirds received the flu vaccine, three-quarters received at least two doses of the COVID vaccine, and 55% also received a booster.

Only 2% of hospitalized COVID-19 cases received outpatient antiviral medications, while 24% received remdesivir during inpatient care. For influenza, oseltamivir was administered in 6% outpatients and 82% in hospitals.

Limitations cited by the study authors include those common in most VA studies (older, predominantly male populations) and the fact that the results do not reflect differences in risk among non-hospitalized cases. It contained the fact that it was possible. Also, the cause of death was not analyzed and may remain confounded.