Near real-time severe acute respiratory illness surveillance characterising influenza and Covid-19 epidemiology in hospitalised adults, 2021-22

Abstract

Objectives: We report the findings of a novel enhanced syndromic surveillance which characterised influenza- and SARS-CoV-2-associated severe acute respiratory illness (SARI) in the 2021/2022 winter season. Methods: Prospective cohort study of adults admitted to the Queen Elizabeth University Hospital, Glasgow, with a severe acute respiratory illness. Patient demographics, clinical history, admission details, and outcome were recorded. Data were available to Public Health Scotland (PHS) and clinicians weekly. Results: Between November 2021 and May 2022, 1,063 hospitalised SARI episodes in 1,037 adult patients were identified. Median age was 72.0 years and 44.5% were male. Most (82.6%) SARI cases had >1 co-morbidity; chronic lung disease (50.0%) and malignancy (22.5%) were the most frequently reported. Overall, 229 (22%) and 33 (3%) SARI episodes were SARS-CoV-2 and influenza A PCR positive, respectively. 74.7%, 6.5% and 43.0% SARI episodes received antibiotics, antivirals, and steroids, respectively (54.5, 11.0 and 51.3% among COVID-19 patients). 1.1% required mechanical ventilation and 7.8% died. Male sex, multimorbidity, frailty, respiratory rate >30, low GCS and chest X-ray consolidation were predictive of in-hospital mortality. Conclusion: Near real-time hospitalised SARI syndromic surveillance characterised the evolving clinical epidemiology of SARS-CoV-2 and influenza, high antimicrobial use, and predictors of inpatient mortality among hospitalised SARI patients.

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http://creativecommons.org/licenses/by/4.0/

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DOI

http://dx.doi.org/10.1016/j.jinf.2024.106338

Repository URI

https://eprints.gla.ac.uk/340146/