Abstract
Infections with SARS-CoV-2 spread worldwide early in 2020. In previous winters, we had been treating patients with seasonal influenza. While creating a larger impact on the health care systems, comparisons regarding the intensive care unit (ICU) courses of both diseases are lacking. We compared patients with influenza and SARS-CoV-2 infections treated at a tertiary care facility offering treatment for acute respiratory distress syndrome (ARDS) and being a high-volume facility for extracorporeal membrane oxygenation (ECMO). Patients with COVID-19 during the first wave of the pandemic (n = 64) were compared to 64 patients with severe influenza from 2016 to 2020 at our ICU. All patients were treated using a standardized protocol. ECMO was used in cases of severe ARDS. Both groups had similar comorbidities. Time in ICU and mortality were not significantly different, yet mortality with ECMO was high amongst COVID-19 patients with approximately two-thirds not surviving. This is in contrast to a mortality of less than 40% in influenza patients with ECMO. Mortality was higher than estimated by SAPSII score on admission in both groups. Patients with COVID-19 were more likely to be male and non-smokers than those with influenza. The outcomes for patients with severe disease were similar. The study helps to understand similarities and differences between patients treated for severe influenza infections and COVID-19.
Highlights
Infections with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1] were first discovered in China [2,3], but rapidly spread worldwide during the first wave of the COVID-19 pandemic in the spring of 2020
During the first wave of the COVID-19 pandemic (January–July 2020), the number of COVID-19 patients admitted to our intensive care unit (ICU) equaled the number of influenza patients in four consecutive flu seasons combined
While our intensive care unit faces a large number of acute respiratory distress syndrome (ARDS) patients with influenza each season, the numbers treated during the COVID-19 pandemic were much higher
Summary
Infections with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1] were first discovered in China [2,3], but rapidly spread worldwide during the first wave of the COVID-19 pandemic in the spring of 2020. One third of the patients treated for COVID-19 have to be admitted to the intensive care unit (ICU) [4]. These patients are a serious burden on healthcare systems globally [5,6], exhausting ICU resources in many countries and straining providers [7]. Seasonal waves of viral disease leading to large numbers of cases needing ventilatory support up to ECMO have been observed in patients infected with the influenza virus. Circulating strains vary annually, altering the effectiveness of vaccinations with vaccines needing adjustments for every flu season [12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
