RT Journal Article
SR Electronic
T1 Characteristics and outcomes of hospital admissions for COVID-19 and influenza in the Toronto area
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E410
OP E418
DO 10.1503/cmaj.202795
VO 193
IS 12
A1 Verma, Amol A.
A1 Hora, Tejasvi
A1 Jung, Hae Young
A1 Fralick, Michael
A1 Malecki, Sarah L.
A1 Lapointe-Shaw, Lauren
A1 Weinerman, Adina
A1 Tang, Terence
A1 Kwan, Janice L.
A1 Liu, Jessica J.
A1 Rawal, Shail
A1 Chan, Timothy C.Y.
A1 Cheung, Angela M.
A1 Rosella, Laura C.
A1 Ghassemi, Marzyeh
A1 Herridge, Margaret
A1 Mamdani, Muhammad
A1 Razak, Fahad
YR 2021
UL http://www.cmaj.ca/content/193/12/E410.abstract
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.