Comparing Clinical Characteristics of Influenza and Common Coronavirus Infections Using Electronic Health Records

Background. We compared outcomes in inpatients and outpatients, pre-COVID-19, who were infected with either coronavirus or influenza. Methods. Using deidentified electronic health records data from the Geisinger-Regeneron partnership, we compared patients with RT-PCR-positive tests for the 4 common coronaviruses (229E, HKU1, NL63, OC43) or influenza (A and B) from June 2016 to February 2019. Results. Overall, 52 833 patients were tested for coronaviruses and influenza. For patients >= 21 years old, 1555 and 3991 patient encounters had confirmed positive coronavirus and influenza tests, respectively. Both groups had similar intensive care unit (ICU) admission rates (7.2% vs 6.1%, P = .12), although patients with coronavirus had significantly more pneumonia (15% vs 7.4%, P < .001) and higher death rate within 30 days (4.9% vs 3.0%, P < .001). After controlling for other covariates, coronavirus infection still had a higher risk of death and pneumonia than influenza (odds ratio, 1.64 and 2.05, P < .001), with no significant difference in ICU admission rates. Conclusions. Common coronaviruses cause significant morbidity, with potentially worse outcomes than influenza. Identifying a subset of patients who are more susceptible to poor outcomes from common coronavirus infections may help plan clinical interventions in patients with suspected infections.

Automated summary

This study compared results in inpatients and outpatients infected with coronavirus or influenza, finding that coronavirus patients had significantly higher rates of pneumonia and death within 30 days compared to influenza patients. Coronaviruses also showed a higher risk of death and pneumonia compared to influenza, despite no significant difference in ICU admission rates.