Monday, June 5, 2023
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Health Sciences Clinical Professor of Family Medicine
University of California, Irvine School of Medicine
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This activity is intended for primary care physicians, hospitalists, infectious disease specialists, nurses, pharmacists, physician assistants and other clinicians who treat and manage patients admitted to the hospital with COVID-19 or influenza.
The goal of this activity is for learners to be better able to compare rates of in-hospital mortality and intensive care unit admission among adults with COVID-19 or influenza.
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Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
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Health Sciences Clinical Professor of Family Medicine
University of California, Irvine School of Medicine
This activity has been peer reviewed and the reviewer has no relevant financial relationships.
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The COVID-19 pandemic has shifted considerably since the advent of the Omicron variant at the end of 2021. It is clear that Omicron more effectively eludes the primary SARS-CoV-2 vaccination series compared with previous variants, which prompted the development of 2 bivalent booster vaccines designed to improve activity against Omicron. But how effective have these bivalent boosters been? A recent study by Lin and colleagues, published in the February 23, 2023, issue of the New England Journal of Medicine, addressed this issue.[1]
Researchers had access to a large cohort of more than 6 million individuals living in the US from September 1 to November 3, 2022; 17.0% of eligible patients received the bivalent booster. Booster effectiveness against severe infection peaked at 4 weeks and then waned thereafter. The rates of vaccine effectiveness against severe COVID-19 infection, resulting in hospitalization, in comparing the monovalent older vaccine with the newer bivalent vaccine were 25.2% and 58.7%. The respective rates of vaccine effectiveness against the combination of hospitalization or death were 24.9% and 61.8%. Estimates of efficacy were similar in comparing the Pfizer-BioNTech and Moderna bivalent booster vaccines, and the improved relative effectiveness of the bivalent vaccines was sustained in an analysis of adults at age 65 years or older.
Despite evidence to the contrary, some loud voices continue to state that the clinical sequelae of COVID-19 are no worse than those of influenza. The current study compares hospital outcomes of adults admitted with influenza infection vs infection with SARS-CoV-2 during Omicron predominance.
COVID-19 remains deadlier than influenza in severe cases requiring hospitalization, a new study shows.
People who were hospitalized with Omicron COVID-19 infections were 54% more likely to die compared with people who were hospitalized with influenza, Swiss researchers found.
The results of the study continue to debunk an earlier belief from the start of the pandemic that influenza was the more dangerous of the 2 respiratory viruses. Researchers noted that the deadliness of COVID-19 compared with influenza persisted “despite virus evolution and improved management strategies.”
The study was published February 15 in JAMA Network Open and included 5212 patients in Switzerland hospitalized with COVID-19 or influenza. All the patients with COVID-19 were infected with the Omicron variant and were hospitalized between January 15, 2022, and March 15, 2022. Influenza data included cases from January 2018 to March 15, 2022.
Overall, 7.0% of patients with COVID-19 died compared with 4.4% of patients with influenza. Researchers noted that the death rate for hospitalized patients with COVID-19 had declined since their previous study, which was conducted during the first COVID-19 wave in the first half of 2020. At that time, the death rate of hospitalized patients with COVID-19 was 12.8%.
Since then, 98% of the Swiss population has been vaccinated. “Vaccination still plays a significant role regarding the main outcome,” the authors conclude, as a secondary analysis in this most recent study showed that unvaccinated patients with COVID-19 were twice as likely to die compared with patients with influenza.
“Our results demonstrate that COVID-19 still cannot simply be compared with influenza,” they write.
Although the death rate among patients with COVID-19 was significantly higher, there was no difference in the rate that patients with COVID-19 or influenza were admitted to the intensive care unit, which was around 8%.
A limitation of the study was that all the COVID-19 cases did not have laboratory testing to confirm the Omicron variant. However, study authors noted that Omicron accounted for at least 95% of cases during the time the patients were hospitalized. The authors stated that they were confident that their results were not biased by the potential for other variants being included in the data.
JAMA Netw Open. 2023;6(2):e2255599.
