Comparison of COVID-19 and Influenza-Related Outcomes in the United States during Fall-Winter 2022-2023

Abstract

AbstractBackgroundThree years into the pandemic, SARS-COV-2 remains a significant burden in comparison to other respiratory illnesses; however, many of the monitoring tools available during the early phase of the COVID-19 pandemic have been phased out, making it more difficult to track the current burden of outpatient medical encounters and hospitalizations, especially for at-risk groups. The objective of this analysis was to characterize the frequency and severity of medically-attended COVID-19 and influenza during peak influenza activity in the pediatric (0-17), adult (18-64), and older adult (65+) populations and characterize the prevalence of underlying medical conditions among patients hospitalized with COVID-19.MethodsThis was a cross-sectional analysis of individuals in the Veradigm Health Insights EHR Database linked to Komodo claims data with a medical encounter of claim between October 1, 2022, and March 31, 2023. We captured age, sex, and underlying medical conditions associated with higher risk for severe COVID-19 during a 12-month baseline period. We identified patients with medical encounters with a diagnosis of COVID-19 or influenza between October 1, 2022, and March 31, 2023, and stratified them into 5 mutually exclusive categories based on the highest level of care received with that diagnosis during the season (intensive care unit [ICU] > hospitalization without ICU > emergency department > urgent care > other outpatient).ResultsAmong the 23,526,196 individuals in the dataset, 5.0% had a COVID-19-related medical encounter, and 3.0% had an influenza-related medical encounter during the 6 month observation period. The incidence of hospitalizations with a COVID-19 diagnosis was 4.6 times higher than the incidence of hospitalizations with an influenza diagnosis. Hospitalizations with COVID-19 were higher in all age groups. Nearly all adults hospitalized with COVID-19 had at least one underlying medical condition, but 25.8% of 0-5-year-olds and 18.3% of 6-17-year-olds had no underlying medical conditions.ConclusionsCOVID-19 continues to place a heavy burden on the United States healthcare system and was associated with more medical encounters in all age groups, including hospitalizations, than influenza during a 6-month period that included the 2022-2023 peak influenza activity.