COVID-19 Hospitalization Raises Long-Term Mortality Risk Compared to Seasonal Flu: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in The Lancet Infectious Diseases that compared both acute and long-term risks and burdens associated with hospitalization for COVID-19 vs seasonal influenza.

The study

Researchers used the health-care databases of the US Department of Veterans Affairs to analyze data from 92 265 hospitalized patients (mean age, 70.7 years; 74.2% White; 95.0% men). A total of 81 280 patients (mean age, 70.8 years) were hospitalized with COVID-19 infection between March 2020 and June 2022 and 10 985 patients (mean age, 70.5 years) were hospitalized for seasonal influenza between October 2015 and February 2019.

During 18 months of follow-up, the researchers evaluated and compared between the 2 groups the risk and burden of death, a prespecified set of 94 adverse health outcomes across 10 organ systems, overall burden across organ systems, hospital readmission, and admission to intensive care.

The findings

Results showed that over the 18 months of follow-up, the mortality rate was consistently higher among participants in the COVID-19 group. At 540 days, for example, the cumulative mortality rate per 100 persons was 28.46 (95% CI, 28.14-28.78) for participants in the COVID-19 group and 19.84 (95% CI, 19.07-20.59) for those in the influenza arm. Also, the excess death rate in the COVID-19 group vs the seasonal influenza group was 8.62 (95% CI, 7.55-9.44) per 100 persons.

When investigators examined the comparative risks of 94 prespecified health outcomes across 10 organ systems, they found that patients in the COVID-19 group were more likely to experience 64 (68.1%) of the outcomes, including cardiovascular, hematologic, gastrointestinal, mental health, metabolic, musculoskeletal, neurologic, and kidney outcomes.

Compared to participants in the influenza group, those in the COVID-19 arm also had an increased risk of hospital readmission (HR, 1.11; 95% CI, 1.08-1.13) and a higher risk of admission to the intensive care unit (HR, 1.27; 95% CI, 1.19-1.36).

Authors' comment

“Altogether, these findings emphasize the need to reduce the risk of infection and hospital admission due to SARS-CoV-2 and seasonal influenza and the need for post-acute care strategies to reduce the burden of health loss in populations.”

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