• Donatien de Marignan, Charles-Hervé Vacheron, Florence Ader, Maxime Lecocq, Jean Christophe Richard, Emilie Frobert, Jean Sebastien Casalegno, Sandrine Couray-Targe, Laurent Argaud, Thomas Rimmele, Frédéric Aubrun, Frédéric Dailler, Jean Luc Fellahi, Julien Bohe, Vincent Piriou, Bernard Allaouchiche, Arnaud Friggeri, and Florent Wallet.
• From the Service de Médecine Intensive Réanimation anesthésie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite (DdM, C-HV, ML, JB, VP, BA, AF, FW), Service de Bio statistique - Bio-informatique, Pôle Santé Publique (C-HV), Service de Maladies infectieuses et tropicales, Hôpital de la Croix Rousse, Hospices Civils de Lyon (FAd), Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, ENS Lyon, Claude Bernard Lyon University (FAd, FW), Service de Médecine Intensive Réanimation, Hôpital De La Croix Rousse, Hospices Civils de Lyon (CR), Université de Lyon, Université Claude Bernard Lyon 1, INSA-Lyon, UJM-Saint Etienne, CNRS, Inserm, CREATISUMR5220, U1206 (JCR), LaboratoiredeVirologie, Institutdes Agents Infectieux (IAI), Hospices Civilsde Lyon (EF, JSC), Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, Team VirPatH, ENS Lyon, Claude Bernard Lyon University (EF, JSC), Pôlede Santé Publique, Departementd'Information Médicale, Hôpital De La Croix Rousse (SC-T), Service de médecine intensive réanimation, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (LA), Service d'anesthésie réanimation, Hôpital Edouard Herriot, Hospices Civilsde Lyon, Lyon (TR), Service d'Anesthéesie réanimation, Hôpital de la Croix Rousse, Hospices Civilsde Lyon, Lyon (FAu), Service d'anesthésie réanimation, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Lyon (FD), Service d'Anesthésie réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron (JLF), Health Services and Performance Research - HESPER, Université Claude Bernard Lyon 1, Facultedé Médecine, Lyon (VP), Pulmonary and Cardiovascular Agression in Sepsis (APCSe), and Universitée de Lyon, VetAgro Sup, Campus Vétérinaire de Lyon, UPSP 2016. A101, Marcy l'Étoile, France (BA).
• Eur J Anaesthesiol. 2022 May 1; 39 (5): 427435427-435.

BackgroundSARS-Cov-2 (COVID-19) has become a major worldwide health concern since its appearance in China at the end of 2019.ObjectiveTo evaluate the intrinsic mortality and burden of COVID-19 and seasonal influenza pneumonia in ICUs in the city of Lyon, France.DesignA retrospective study.SettingSix ICUs in a single institution in Lyon, France.PatientsConsecutive patients admitted to an ICU with SARS-CoV-2 pneumonia from 27 February to 4 April 2020 (COVID-19 group) and seasonal influenza pneumonia from 1 November 2015 to 30 April 2019 (influenza group). A total of 350 patients were included in the COVID-19 group (18 refused to consent) and 325 in the influenza group (one refused to consent). Diagnosis was confirmed by RT-PCR. Follow-up was completed on 1 April 2021.Main Outcomes And MeasuresDifferences in 90-day adjusted-mortality between the COVID-19 and influenza groups were evaluated using a multivariable Cox proportional hazards model.ResultsCOVID-19 patients were younger, mostly men and had a higher median BMI, and comorbidities, including immunosuppressive condition or respiratory history were less frequent. In univariate analysis, no significant differences were observed between the two groups regarding in-ICU mortality, 30, 60 and 90-day mortality. After Cox modelling adjusted on age, sex, BMI, cancer, sepsis-related organ failure assessment (SOFA) score, simplified acute physiology score SAPS II score, chronic obstructive pulmonary disease and myocardial infarction, the probability of death associated with COVID-19 was significantly higher in comparison to seasonal influenza [hazard ratio 1.57, 95% CI (1.14 to 2.17); P = 0.006]. The clinical course and morbidity profile of both groups was markedly different; COVID-19 patients had less severe illness at admission (SAPS II score, 37 [28 to 48] vs. 48 [39 to 61], P < 0.001 and SOFA score, 4 [2 to 8] vs. 8 [5 to 11], P < 0.001), but the disease was more severe considering ICU length of stay, duration of mechanical ventilation, PEEP level and prone positioning requirement.ConclusionAfter ICU admission, COVID-19 was associated with an increased risk of death compared with seasonal influenza. Patient characteristics, clinical course and morbidity profile of these diseases is markedly different.Copyright © 2022 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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