PT  - JOURNAL ARTICLE
AU  - Verma, Amol A.
AU  - Hora, Tejasvi
AU  - Jung, Hae Young
AU  - Fralick, Michael
AU  - Malecki, Sarah L.
AU  - Lapointe-Shaw, Lauren
AU  - Weinerman, Adina
AU  - Tang, Terence
AU  - Kwan, Janice L.
AU  - Liu, Jessica J.
AU  - Rawal, Shail
AU  - Chan, Timothy C.Y.
AU  - Cheung, Angela M.
AU  - Rosella, Laura C.
AU  - Ghassemi, Marzyeh
AU  - Herridge, Margaret
AU  - Mamdani, Muhammad
AU  - Razak, Fahad
TI  - Characteristics and outcomes of hospital admissions for COVID-19 and influenza in the Toronto area
AID  - 10.1503/cmaj.202795
DP  - 2021 Mar 22
TA  - Canadian Medical Association Journal
PG  - E410--E418
VI  - 193
IP  - 12
4099  - http://www.cmaj.ca/content/193/12/E410.short
4100  - http://www.cmaj.ca/content/193/12/E410.full
SO  - CMAJ2021 Mar 22; 193
AB  - BACKGROUND: Patient characteristics, clinical care, resource use and outcomes associated with admission to hospital for coronavirus disease 2019 (COVID-19) in Canada are not well described.METHODS: We described all adults with COVID-19 or influenza discharged from inpatient medical services and medical–surgical intensive care units (ICUs) between Nov. 1, 2019, and June 30, 2020, at 7 hospitals in Toronto and Mississauga, Ontario. We compared patient outcomes using multivariable regression models, controlling for patient sociodemographic factors and comorbidity level. We validated the accuracy of 7 externally developed risk scores to predict mortality among patients with COVID-19.RESULTS: There were 1027 hospital admissions with COVID-19 (median age 65 yr, 59.1% male) and 783 with influenza (median age 68 yr, 50.8% male). Patients younger than 50 years accounted for 21.2% of all admissions for COVID-19 and 24.0% of ICU admissions. Compared with influenza, patients with COVID-19 had significantly greater in-hospital mortality (unadjusted 19.9% v. 6.1%, adjusted relative risk [RR] 3.46, 95% confidence interval [CI] 2.56–4.68), ICU use (unadjusted 26.4% v. 18.0%, adjusted RR 1.50, 95% CI 1.25–1.80) and hospital length of stay (unadjusted median 8.7 d v. 4.8 d, adjusted rate ratio 1.45, 95% CI 1.25–1.69). Thirty-day readmission was not significantly different (unadjusted 9.3% v. 9.6%, adjusted RR 0.98, 95% CI 0.70–1.39). Three points-based risk scores for predicting in-hospital mortality showed good discrimination (area under the receiver operating characteristic curve [AUC] ranging from 0.72 to 0.81) and calibration.INTERPRETATION: During the first wave of the pandemic, admission to hospital for COVID-19 was associated with significantly greater mortality, ICU use and hospital length of stay than influenza. Simple risk scores can predict in-hospital mortality in patients with COVID-19 with good accuracy.