Table 2.
Clinical manifestations in patients admitted to hospital with seasonal influenza and coronavirus disease 2019 (covid-19)
| Clinical manifestations | Seasonal influenza (n=12 676)—No (%) | Covid-19 (n=3641)—No (%) | Unadjusted OR* (95% CI) | Adjusted OR* † (95% CI) | Excess outcomes per 100 patients* ‡ (95% CI) |
|---|---|---|---|---|---|
| Any acute kidney injury | 3670 (29.0) | 1355 (37.2) | 1.46 (1.35 to 1.57) | 1.52 (1.37 to 1.69) | 5.81 (5.35 to 6.27) |
| Acute kidney injury stage 2 or above | 638 (5.0) | 538 (14.8) | 3.27 (2.90 to 3.69) | 3.16 (2.74 to 3.64) | 8.06 (6.49 to 9.85) |
| Acute kidney injury stage 3 | 408 (3.2) | 397 (10.9) | 3.68 (3.19 to 4.25) | 3.43 (2.90 to 4.06) | 5.97 (4.57 to 7.66) |
| Incident renal replacement therapy§ | 113/12 128 (0.9) | 160/3430 (4.7) | 5.20 (4.08 to 6.64) | 4.11 (3.13 to 5.40) | 2.77 (1.63 to 4.63) |
| Incident insulin use¶ | 1048/8484 (12.4) | 555/2412 (23.0) | 2.12 (1.89 to 2.38) | 1.86 (1.62 to 2.14) | 9.35 (8.31 to 10.29) |
| Severe septic shock | 300 (2.4) | 319 (8.8) | 3.96 (3.37 to 4.66) | 4.04 (3.38 to 4.83) | 6.36 (4.48 to 8.87) |
| Vasopressor use | 613 (4.8) | 595 (16.3) | 3.84 (3.41 to 4.33) | 3.95 (3.46 to 4.51) | 11.47 (9.10 to 14.22) |
| Pulmonary embolism | 262 (2.1) | 118 (3.2) | 1.59 (1.27 to 1.98) | 1.50 (1.18 to 1.90) | 1.00 (0.59 to 1.69) |
| Deep venous thrombosis | 285 (2.3) | 141 (3.9) | 1.75 (1.43 to 2.15) | 1.50 (1.20 to 1.88) | 1.13 (0.69 to 1.83) |
| Stroke | 124 (1.0) | 69 (1.9) | 1.96 (1.45 to 2.63) | 1.62 (1.17 to 2.24) | 0.62 (0.30 to 1.25) |
| Acute myocarditis | 10 (0.1) | 23 (0.6) | 8.05 (3.83 to 16.92) | 7.82 (3.53 to 17.36) | 0.53 (0.11 to 2.63) |
| Arrythmias and sudden cardiac death | 275 (2.2) | 138 (3.8) | 1.78 (1.44 to 2.19) | 1.76 (1.40 to 2.20) | 1.57 (0.97 to 2.51) |
| Troponin >0.4 ng/mL | 654 (5.2) | 311 (8.5) | 1.73 (1.51 to 1.99) | 1.75 (1.50 to 2.05) | 3.37 (2.50 to 4.47) |
| Aspartate aminotransferase: | |||||
| >40 IU/L | 3694 (29.1) | 2104 (57.8) | 3.33 (3.08 to 3.59) | 3.16 (2.91 to 3.43) | 27.00 (26.00 to 27.71) |
| >5 times upper limit of normal** | 279 (2.2) | 204 (5.6) | 2.64 (2.19 to 3.17) | 2.38 (1.94 to 2.91) | 2.90 (1.90 to 4.35) |
| Alanine aminotransferase: | |||||
| >40 IU/L | 3154 (24.9) | 1697 (46.6) | 2.64 (2.44 to 2.84) | 2.65 (2.43 to 2.88) | 21.12 (19.81 to 22.26) |
| >5 times upper limit of normal †† | 311 (2.5) | 309 (8.5) | 3.46 (2.95 to 4.06) | 3.33 (2.80 to 3.97) | 5.54 (3.90 to 7.76) |
| Rhabdomyolysis: | |||||
| CPK >1000 IU/L | 411 (3.2) | 274 (7.5) | 2.43 (2.08 to 2.84) | 1.84 (1.54 to 2.18) | 2.65 (1.87 to 3.72) |
| CPK >5000 IU/L | 94 (0.7) | 43 (1.2) | 1.60 (1.11 to 2.30) | 1.20 (0.81 to 1.77) | 0.15 (−0.06 to 0.42) |
| CPK >5× upper limit of normal ‡‡ | 288 (2.3) | 181 (5.0) | 2.25 (1.86 to 2.72) | 1.66 (1.35 to 2.04) | 1.53 (0.98 to 2.35) |
CPK=creatine phosphokinase; OR=odds ratio.
Seasonal influenza group served as reference.
Models adjusted for age, sex, race, smoking status, body mass index, estimated glomerular filtration rate, chronic lung disease, cancer, cardiovascular disease, cerebrovascular disease, dementia, diabetes mellitus, hypertension, peripheral artery disease, and use of statins, angiotensin converting enzyme inhibitors/angiotensin II receptor blockers, and non-steroidal anti-inflammatory drugs.
Excess outcomes per 100 patients due to covid-19 compared with seasonal influenza.
Among patients without history of renal replacement therapy before hospital admission (n=15 558).
Among patients without history of diabetes treatment before hospital admission (n=10 896).
Defined as 240 IU/L for males and 215 IU/L for females.
Defined as 165 IU/L for males and 125 IU/L for females.
Defined as 1540 IU/L for males and 960 IU/L for females.