Despite the fact that the pandemic has been raging in the world for almost a year, many still consider COVID-19 “no worse than the flu.” It was with the flu in terms of mortality and complications that French scientists compared SARS-CoV-2, whose study was published the other day in the authoritative medical journal The Lancet. They analyzed data collected nationally from more than 89,000 patients of all ages hospitalized with COVID-19 during the first wave of the pandemic and compared it with France’s worst 2018-2019 flu season in five years. Mortality from COVID-19 was 3 times higher than mortality from seasonal flu among adults and 4 times among children over 5 years old, and among adolescents – 10 (!) Times.
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Authors articles analyzed the data of 89 530 patients who were hospitalized with confirmed COVID-19 between March 1 and April 30, 2020, and 45 819 patients who were hospitalized for seasonal ARVI and influenza between December 1, 2018 and February 28, 2019 of the year. The researchers emphasize that in the period 2018-19, there was the highest mortality rate from seasonal SARS in France over the past 5 years (12,300 deaths, including 8,100 directly from influenza).
It was immediately apparent that in 2 months of COVID-19, twice as many patients were hospitalized as in 3 months of seasonal flu. Patients hospitalized with COVID-19 were more likely to be men than those hospitalized with influenza. And they were generally younger (average 68 versus 71 for the flu). Patients with COVID-19 were more likely to have obesity or overweight, diabetes, hypertension and dyslipidemia, while those with influenza were more likely to have heart failure, peripheral vascular disease, chronic respiratory disease, cirrhosis, and anemia. If we talk about the consequences of hospitalization, patients with the new coronavirus more often developed acute respiratory failure, pulmonary thromboembolism or septic shock, but less often – myocardial infarction or atrial fibrillation.
Patients with COVID-19 were twice as likely to require mechanical ventilation as patients with influenza, and one in four patients developed acute respiratory failure. Among patients with the flu, only one in five experienced breathing problems. The average length of stay in intensive care for COVID-19 was twice as long (15 days versus 8) than for those hospitalized with influenza. A quarter of patients with coronavirus infection have been in the intensive care unit for more than 3 weeks. Mortality rates for COVID-19 patients admitted to the intensive care unit, whether mechanically ventilated or not, were also higher than those of resuscitators with influenza. Overall, COVID-19 patients died three times more often than those with the flu.
Children under the age of 5 who were admitted to hospitals with COVID-19 were more likely to end up in intensive care than their peers with the flu, but their mortality rates did not differ much. In contrast to the mortality rate in the group of children 11-17 years old: it was 10 times higher in patients with COVID-19 than in patients with influenza. Small patients with COVID-19 were more likely to be obese, but less likely to have diabetes or chronic respiratory diseases. Although the risk of hospitalization for COVID-19 in children is generally lower than for influenza, the mortality of these children in hospital was more than four times higher than that of children with influenza. The increase in infant mortality may be partly related to Inflammatory multisystem syndrome in children, the researchers note, which occurs “unexpectedly often” with COVID-19, including in adolescents.
As “MK” was told by the associate professor of the Department of Infectious Diseases in Children of the PF RNIMU N.I. Pirogov Ivan Konovalov, in all age groups, except for children under 5-7 years old, mortality from the new type of coronavirus is much higher: “This is due not only to the severity of the disease itself, but also to the fact that SARS-CoV-2 coronavirus is susceptible all people on the planet, since this is a new pathogen. Therefore, long-term observations of the lethality (direct and indirect) in influenza show that both taking into account vaccination and taking into account the secondary immune response, the lethality in influenza is still significantly lower. take into account that specific antiviral drugs have been developed against influenza, which also have a significant effect in preventing severe and fatal cases.Despite the fact that young children tolerate a new coronavirus infection more easily and often without symptoms, in some cases they develop multisystem inflammatory syndrome ( Kawasaki-like), which often occurs in severe forms. “
Meanwhile, some researchers point out that this year the flu has disappeared altogether. As the doctor of medical sciences, professor Vasily Vlasov notes in his social network, since spring he warned that influenza during the coronavirus pandemic fades into the background: “Today in Russia, out of more than 2,500 flu tests, only one is positive, in November. Influenza has not been detected for more than six months. It practically disappeared in April in the collected samples. And today, by the new year, it is still not. This is evidenced by international data – graphs are published on the WHO website. ” “The fact that there would be no flu was already clear at the end of August, according to statistics from the Southern Hemisphere,” agreed Dr. Yuri Meshchersky.
“The flu hasn’t disappeared anywhere,” Ivan Konovalov objects, meanwhile. “But due to isolation measures and the massive use of personal protective equipment, the transmission of respiratory infections, including influenza, has decreased. We must take into account the fact that influenza infections in Russia often begin in January, and we can only track how the influenza season proceeds after its end, in the spring. Data from China, one of the countries with the lowest coverage of influenza vaccination have shown that co-infections of influenza and COVID-19 can be more severe, and this is especially true for children.Accordingly, it should be remembered that the transferred coronavirus infection can be accompanied by long-term and persistent health problems that can lead to a more severe course of influenza infection, and vice versa – the transferred influenza can cause immunosuppression, which is an unfavorable factor for the severity of COVID-1 nine. It is worth mentioning the experience of several countries in studying the course of COVID-19 among those vaccinated against influenza or not. Thus, studies conducted in Brazil among more than 90 thousand people showed that influenza vaccination significantly reduces hospitalization for COVID-19, significantly reduces the chances of needing to be transferred to mechanical ventilation and the number of deaths. “
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