Ainara Mira-Iglesias, Mónica López-Lacort, Hélène Bricout, Matthew Loiacono, Mario Carballido-Fernández, Joan Mollar-Maseres, Miguel Tortajada-Girbés, Germán Schwarz-Chávarri, F. Xavier López-Labrador, Joan Puig-Barberà, Javier Díez-Domingo, Alejandro Orrico-Sánchez
Background
International Classification of Diseases (ICD) codes obtained from real-world data can be used to identify influenza cases for epidemiological research but, without validation, may introduce biases. The objective of this study was to validate ICD influenza discharge diagnoses using real-time reverse transcription-polymerase chain reaction (RT-PCR) laboratory-confirmed influenza (LCI) results.
Methods
The study was conducted during six influenza seasons (2012/2013–2017/2018) in the Valencia Hospital Surveillance Network for the Study of Influenza (VAHNSI). Patients aged 18+ years were identified via active-surveillance and had to meet an influenza-like illness (ILI) case definition to be included. All patients were tested for influenza by real-time RT-PCR. Main and secondary influenza discharge diagnosis codes were extracted from hospital discharge letters. Positive predictive values (PPVs) and the complementary of the sensitivities (1-Sensitivity) of ICD codes with corresponding 95% credible intervals (CrIs) were estimated via binomial Bayesian regression models.
Results
A total of 13,545 patients were included, with 2257 (17%) positive for influenza. Of 2257 LCI cases, 1385 (61%) were not ICD-coded as influenza. Overall, 74.73% (95% CrI: 63.24–84.44) of LCI were not-ICD coded as influenza (1-Sensitivity) after adjustment. Sensitivity improved across seasons and with increasing age. Average PPV was 74.02% (95% CrI: 68.58–79.17), ranging from 43.71% to 81.57% between seasons.
Conclusion
Using only main and secondary discharge diagnosis codes for influenza detection markedly underestimates the full burden of influenza in hospitalized patients. Future studies, including post-COVID context, using prospective surveillance for ILI are required to assess the validity of hospital discharge data as a tool for determining influenza-related burden of disease.
{"title":"Accuracy of ICD Influenza Discharge Diagnosis Codes in Hospitalized Adults From the Valencia Region, Spain, in the Pre-COVID-19 Period 2012/2013 to 2017/2018","authors":"Ainara Mira-Iglesias, Mónica López-Lacort, Hélène Bricout, Matthew Loiacono, Mario Carballido-Fernández, Joan Mollar-Maseres, Miguel Tortajada-Girbés, Germán Schwarz-Chávarri, F. Xavier López-Labrador, Joan Puig-Barberà, Javier Díez-Domingo, Alejandro Orrico-Sánchez","doi":"10.1111/irv.70069","DOIUrl":"https://doi.org/10.1111/irv.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>International Classification of Diseases (ICD) codes obtained from real-world data can be used to identify influenza cases for epidemiological research but, without validation, may introduce biases. The objective of this study was to validate ICD influenza discharge diagnoses using real-time reverse transcription-polymerase chain reaction (RT-PCR) laboratory-confirmed influenza (LCI) results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was conducted during six influenza seasons (2012/2013–2017/2018) in the Valencia Hospital Surveillance Network for the Study of Influenza (VAHNSI). Patients aged 18+ years were identified via active-surveillance and had to meet an influenza-like illness (ILI) case definition to be included. All patients were tested for influenza by real-time RT-PCR. Main and secondary influenza discharge diagnosis codes were extracted from hospital discharge letters. Positive predictive values (PPVs) and the complementary of the sensitivities (1-Sensitivity) of ICD codes with corresponding 95% credible intervals (CrIs) were estimated via binomial Bayesian regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 13,545 patients were included, with 2257 (17%) positive for influenza. Of 2257 LCI cases, 1385 (61%) were not ICD-coded as influenza. Overall, 74.73% (95% CrI: 63.24–84.44) of LCI were not-ICD coded as influenza (1-Sensitivity) after adjustment. Sensitivity improved across seasons and with increasing age. Average PPV was 74.02% (95% CrI: 68.58–79.17), ranging from 43.71% to 81.57% between seasons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Using only main and secondary discharge diagnosis codes for influenza detection markedly underestimates the full burden of influenza in hospitalized patients. Future studies, including post-COVID context, using prospective surveillance for ILI are required to assess the validity of hospital discharge data as a tool for determining influenza-related burden of disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valérie D. V. Sankatsing, Jojanneke van Summeren, Fasika Molla Abreha, Elisabetta Pandolfi, Maria Chironna, Daniela Loconsole, Rolf Kramer, John Paget, Caterina Rizzo
Background
Accurate cost estimates of respiratory syncytial virus (RSV) infections in primary care are limited, despite the majority of cases being managed in this setting. This study aims to estimate healthcare costs for children with RSV in primary care and the related costs of parental work absence.
Methods
Children < 5 years of age with symptoms of acute respiratory infections were recruited via primary care paediatricians in two Italian regions for a prospective cohort study on the RSV burden in primary care, during the 2019/2020 winter. Healthcare utilization, medication use and parental work absence were assessed during a 14-day follow-up period. Average costs were estimated per RSV episode for the overall study population, as well as per age group.
Results
Two hundred ninety three children were recruited, of which 119 tested RSV positive (41%) and 109 were included. In total, 89% of RSV-positive children (97/109) had ≥ 1 repeat paediatrician visit(s), and 10% (11/109) visited the ED. The mean number of repeat visits was 3.8 (SD: 4.0) and the mean duration of work absence 4.0 days (SD: 5.0). Average costs per RSV episode were €730 (95% CI: €691–€771), with direct medical costs accounting for 25% (€183 [95% CI: €174–€191]) and indirect costs related to work absence for 75% (€547 [95% CI: €509–€587]).
Conclusions
Costs associated with RSV infections in young children in primary care are considerable due to a substantial number of paediatrician visits and high rates of parental work absence. These costs are important to include in decision-making regarding the implementation of new RSV immunization strategies in national immunization programmes.
{"title":"Economic Impact of Respiratory Syncytial Virus Infections in Children Under 5 Years of Age Attending Primary Care in Italy: A Prospective Cohort Study in Two Regions","authors":"Valérie D. V. Sankatsing, Jojanneke van Summeren, Fasika Molla Abreha, Elisabetta Pandolfi, Maria Chironna, Daniela Loconsole, Rolf Kramer, John Paget, Caterina Rizzo","doi":"10.1111/irv.70074","DOIUrl":"10.1111/irv.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Accurate cost estimates of respiratory syncytial virus (RSV) infections in primary care are limited, despite the majority of cases being managed in this setting. This study aims to estimate healthcare costs for children with RSV in primary care and the related costs of parental work absence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Children < 5 years of age with symptoms of acute respiratory infections were recruited via primary care paediatricians in two Italian regions for a prospective cohort study on the RSV burden in primary care, during the 2019/2020 winter. Healthcare utilization, medication use and parental work absence were assessed during a 14-day follow-up period. Average costs were estimated per RSV episode for the overall study population, as well as per age group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred ninety three children were recruited, of which 119 tested RSV positive (41%) and 109 were included. In total, 89% of RSV-positive children (97/109) had ≥ 1 repeat paediatrician visit(s), and 10% (11/109) visited the ED. The mean number of repeat visits was 3.8 (SD: 4.0) and the mean duration of work absence 4.0 days (SD: 5.0). Average costs per RSV episode were €730 (95% CI: €691–€771), with direct medical costs accounting for 25% (€183 [95% CI: €174–€191]) and indirect costs related to work absence for 75% (€547 [95% CI: €509–€587]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Costs associated with RSV infections in young children in primary care are considerable due to a substantial number of paediatrician visits and high rates of parental work absence. These costs are important to include in decision-making regarding the implementation of new RSV immunization strategies in national immunization programmes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 2","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
SARS-CoV-2, which originated in China in late 2019, quickly fueled the global COVID-19 pandemic, profoundly impacting health and the economy worldwide. A series of vaccines, mostly based on the full SARS-CoV-2 Spike protein, were rapidly developed, showing excellent humoral and cellular responses and high efficacy against both symptomatic infection and severe disease. However, viral evolution and the waning humoral neutralizing responses strongly challenged vaccine long term effectiveness, mainly against symptomatic infection, making necessary a strategy of repeated and updated booster shots. In this repeated vaccination context, antibody repertoire diversification was evidenced, although immune imprinting after booster doses or reinfection was also demonstrated and identified as a major determinant of immunological responses to repeated antigen exposures. Considering that a small domain of the SARS-CoV-2 Spike protein, the receptor binding domain (RBD), is the major target of neutralizing antibodies and concentrates most viral mutations, the following text aims to provide insights into the ongoing debate over the best strategies for vaccine boosters. We address the relevance of developing new booster vaccines that target the evolving RBD, thus focusing on the relevant antigenic sites of the SARS-CoV-2 new variants. A combination of this strategy with immunofusing and computerized approaches could minimize immune imprinting, therefore optimizing neutralizing immune responses and booster vaccine efficacy.
{"title":"Rethinking Optimal Immunogens to Face SARS-CoV-2 Evolution Through Vaccination","authors":"Julià Blanco, Benjamin Trinité, Joan Puig-Barberà","doi":"10.1111/irv.70076","DOIUrl":"10.1111/irv.70076","url":null,"abstract":"<p>SARS-CoV-2, which originated in China in late 2019, quickly fueled the global COVID-19 pandemic, profoundly impacting health and the economy worldwide. A series of vaccines, mostly based on the full SARS-CoV-2 Spike protein, were rapidly developed, showing excellent humoral and cellular responses and high efficacy against both symptomatic infection and severe disease. However, viral evolution and the waning humoral neutralizing responses strongly challenged vaccine long term effectiveness, mainly against symptomatic infection, making necessary a strategy of repeated and updated booster shots. In this repeated vaccination context, antibody repertoire diversification was evidenced, although immune imprinting after booster doses or reinfection was also demonstrated and identified as a major determinant of immunological responses to repeated antigen exposures. Considering that a small domain of the SARS-CoV-2 Spike protein, the receptor binding domain (RBD), is the major target of neutralizing antibodies and concentrates most viral mutations, the following text aims to provide insights into the ongoing debate over the best strategies for vaccine boosters. We address the relevance of developing new booster vaccines that target the evolving RBD, thus focusing on the relevant antigenic sites of the SARS-CoV-2 new variants. A combination of this strategy with immunofusing and computerized approaches could minimize immune imprinting, therefore optimizing neutralizing immune responses and booster vaccine efficacy.</p>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Susanne Heemskerk, Christos Baliatsas, Foekje Stelma, Harish Nair, John Paget, Peter Spreeuwenberg
Background
During the COVID-19 pandemic, atypical respiratory syncytial virus (RSV) circulation patterns emerged, with the occurrence of RSV activity outside the typical winter season. This study investigates the impact of COVID-19 and associated non-pharmaceutical interventions (NPIs) on RSV seasonality.
Methods
The onset, offset and peak of RSV epidemics from 2018 to 2022 across 12 European countries were determined using the 3% positivity threshold method. A multilevel longitudinal logit regression model for proportions assessed the associations between five NPIs (school closures, mask use, workplace measures, public gathering restrictions and closure of public spaces) and RSV, utilising RSV surveillance data, two NPI databases (ECDC-JRC and Oxford) and COVID-19 surveillance data.
Results
Before 2020, consistent RSV seasonality patterns were observed, but the seasonal increase of RSV-positive cases in winter remained absent during the COVID-19 pandemic (2020–2022). Analysis revealed inconsistent associations between individual NPIs and RSV. The associations differed depending on the data source used (ECDC-JRC or Oxford), not only in magnitude but also in the direction of the coefficients. Public gathering restrictions and closure of public spaces exhibited significant negative associations with RSV incidence. However, this was only observed when using surveillance data for the entire epidemiological year and not when only examining weeks with increased RSV activity.
Conclusions
This study highlights the need for standardised international data collection and procedures for infectious disease modelling, as varying NPI implementations, NPI registration and RSV surveillance across countries complicate the understanding of RSV dynamics during the pandemic. Caution is recommended when interpreting the effects of NPIs on RSV circulation.
{"title":"Assessing the Impact of Non-Pharmaceutical Interventions During the COVID-19 Pandemic on RSV Seasonality in Europe","authors":"Susanne Heemskerk, Christos Baliatsas, Foekje Stelma, Harish Nair, John Paget, Peter Spreeuwenberg","doi":"10.1111/irv.70066","DOIUrl":"10.1111/irv.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>During the COVID-19 pandemic, atypical respiratory syncytial virus (RSV) circulation patterns emerged, with the occurrence of RSV activity outside the typical winter season. This study investigates the impact of COVID-19 and associated non-pharmaceutical interventions (NPIs) on RSV seasonality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The onset, offset and peak of RSV epidemics from 2018 to 2022 across 12 European countries were determined using the 3% positivity threshold method. A multilevel longitudinal logit regression model for proportions assessed the associations between five NPIs (school closures, mask use, workplace measures, public gathering restrictions and closure of public spaces) and RSV, utilising RSV surveillance data, two NPI databases (ECDC-JRC and Oxford) and COVID-19 surveillance data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Before 2020, consistent RSV seasonality patterns were observed, but the seasonal increase of RSV-positive cases in winter remained absent during the COVID-19 pandemic (2020–2022). Analysis revealed inconsistent associations between individual NPIs and RSV. The associations differed depending on the data source used (ECDC-JRC or Oxford), not only in magnitude but also in the direction of the coefficients. Public gathering restrictions and closure of public spaces exhibited significant negative associations with RSV incidence. However, this was only observed when using surveillance data for the entire epidemiological year and not when only examining weeks with increased RSV activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the need for standardised international data collection and procedures for infectious disease modelling, as varying NPI implementations, NPI registration and RSV surveillance across countries complicate the understanding of RSV dynamics during the pandemic. Caution is recommended when interpreting the effects of NPIs on RSV circulation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jela Aćimović, Biljana Mijović, Srđan Mašić, Miroslav Petković, Dragana Puhalo Sladoje, Darija Knežević, Jelena Đaković Dević, Dragan Spaić, Jelena Vladičić-Mašić, Dejan Bokonjić, Mirza Palo, Aisling Vaughan, Richard Pebody, Anthony Nardone, Ranko Škrbić
Introduction
The aim of the study was to assess the seroprevalence of SARS-CoV-2 in the Republika Srpska, Bosnia and Herzegovina, after five waves of COVID-19 and 1 year after introduction of vaccination to better understand the true extent of the COVID-19 pandemic in the population of the Republika Srpska and role of vaccination in achieving herd immunity.
Methods
The population-based study was conducted from December 2021 to February 2022 in a group of 4463 individuals in the Republika Srpska. Total anti–SARS-CoV-2 antibodies were determined in serum specimens using the Wantai total antibody ELISA assay. Quantitative analysis, using Kantaro IgG assays, was performed in subsamples (1273 specimens) to asses and compare levels of IgG among vaccinated, recovered and participants with hybrid immunity. To adjust for age and gender distribution in sample, poststratification method is applied.
Results
The overall cumulative seroprevalence was 94.6% (95% CI = 93.9–95.3). Significantly higher seroprevalence rates were observed among vaccinated 97.8% (95% CI = 97.3–98.4) comparing to unvaccinated participants (89.5%, 95% CI = 88.0–91.0). Seroprevalence increases with the number of received doses. Among various professions, the highest seroprevalence was found in the service industry (98.1%), education (98.0%) and healthcare (96.9%). We found that 2.2% of vaccinated and 3.6% of participants with SARS-CoV-2 positivity during 2021 had no detectable IgG antibodies. Both seroprevalence (98.6%) and antibody titres (1094.4 AU/mL) were significantly higher among people with hybrid immunity.
Conclusion
Our findings reveal a 2.3-fold increase in seroprevalence of SARS-CoV-2 antibodies due to infection and vaccination, comparing to the first study performed 1 year earlier. This study provides better understanding of the SARS-CoV-2 transmission and highlights the important role of the vaccination in achieving the population immunity. Periodically conducted population-based seroprevalence studies are important to understand temporal trends and assess surveillance system performance and public compliance with vaccination policies.
本研究的目的是评估波斯尼亚和黑塞哥维那斯普斯卡共和国在经历五波COVID-19和引入疫苗接种一年后的SARS-CoV-2血清患病率，以更好地了解斯普斯卡共和国人口中COVID-19大流行的真实程度以及疫苗接种在实现群体免疫中的作用。方法：这项基于人群的研究于2021年12月至2022年2月在斯普斯卡共和国的4463名个体中进行。采用万泰总抗体ELISA法测定血清标本中总抗sars - cov -2抗体。使用Kantaro IgG测定法对亚样本（1273个样本）进行定量分析，以评估和比较接种疫苗者、康复者和混合免疫者的IgG水平。为了调整样本的年龄和性别分布，采用了后分层方法。结果：总累积血清阳性率为94.6% （95% CI = 93.9 ~ 95.3）。与未接种疫苗的参与者（89.5%,95% CI = 88.0-91.0）相比，接种疫苗的参与者（97.8%,95% CI = 97.3-98.4）的血清患病率显著高于未接种疫苗的参与者（89.5%,95% CI = 88.0-91.0）。血清阳性率随着接受剂量的增加而增加。在不同的职业中，血清阳性率最高的是服务业（98.1%）、教育（98.0%）和医疗保健（96.9%）。我们发现，在2021年期间，2.2%的疫苗接种者和3.6%的SARS-CoV-2阳性参与者没有检测到IgG抗体。混合免疫人群血清阳性率（98.6%）和抗体滴度（1094.4 AU/mL）均显著高于混合免疫人群。结论：我们的研究结果显示，与一年前进行的第一次研究相比，由于感染和接种疫苗，SARS-CoV-2抗体的血清阳性率增加了2.3倍。本研究对SARS-CoV-2的传播提供了更好的认识，并强调了疫苗接种在实现人群免疫中的重要作用。定期开展以人群为基础的血清流行率研究对于了解时间趋势和评估监测系统的表现以及公众对疫苗接种政策的依从性非常重要。
{"title":"The Second Round of a Population-Based Seroprevalence Study of Anti–SARS-CoV-2 Antibodies and COVID-19 Vaccination Assessment in the Republika Srpska, Bosnia and Herzegovina","authors":"Jela Aćimović, Biljana Mijović, Srđan Mašić, Miroslav Petković, Dragana Puhalo Sladoje, Darija Knežević, Jelena Đaković Dević, Dragan Spaić, Jelena Vladičić-Mašić, Dejan Bokonjić, Mirza Palo, Aisling Vaughan, Richard Pebody, Anthony Nardone, Ranko Škrbić","doi":"10.1111/irv.70053","DOIUrl":"10.1111/irv.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The aim of the study was to assess the seroprevalence of SARS-CoV-2 in the Republika Srpska, Bosnia and Herzegovina, after five waves of COVID-19 and 1 year after introduction of vaccination to better understand the true extent of the COVID-19 pandemic in the population of the Republika Srpska and role of vaccination in achieving herd immunity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The population-based study was conducted from December 2021 to February 2022 in a group of 4463 individuals in the Republika Srpska. Total anti–SARS-CoV-2 antibodies were determined in serum specimens using the Wantai total antibody ELISA assay. Quantitative analysis, using Kantaro IgG assays, was performed in subsamples (1273 specimens) to asses and compare levels of IgG among vaccinated, recovered and participants with hybrid immunity. To adjust for age and gender distribution in sample, poststratification method is applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall cumulative seroprevalence was 94.6% (95% CI = 93.9–95.3). Significantly higher seroprevalence rates were observed among vaccinated 97.8% (95% CI = 97.3–98.4) comparing to unvaccinated participants (89.5%, 95% CI = 88.0–91.0). Seroprevalence increases with the number of received doses. Among various professions, the highest seroprevalence was found in the service industry (98.1%), education (98.0%) and healthcare (96.9%). We found that 2.2% of vaccinated and 3.6% of participants with SARS-CoV-2 positivity during 2021 had no detectable IgG antibodies. Both seroprevalence (98.6%) and antibody titres (1094.4 AU/mL) were significantly higher among people with hybrid immunity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings reveal a 2.3-fold increase in seroprevalence of SARS-CoV-2 antibodies due to infection and vaccination, comparing to the first study performed 1 year earlier. This study provides better understanding of the SARS-CoV-2 transmission and highlights the important role of the vaccination in achieving the population immunity. Periodically conducted population-based seroprevalence studies are important to understand temporal trends and assess surveillance system performance and public compliance with vaccination policies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nonpharmaceutical interventions for coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, during the pandemic altered the epidemiology of respiratory viruses. This study aimed to determine the changes in respiratory viruses among children hospitalized from 2018 to 2023.
Methods
Nasopharyngeal specimens were collected from children aged under 15 years with fever and/or respiratory symptoms admitted to a medical institution in Fukushima Prefecture between January 2018 and December 2023. Eighteen respiratory viruses were detected using real-time reverse transcription-polymerase chain reaction.
Results
Overall, 1933 patients were included. Viruses were detected in 1377 (71.2%); of these, a single virus was detected in 906 (46.9%) and multiple viruses in 471 (24.3%). Among the viruses whose epidemics were temporarily suppressed, the epidemics of respiratory syncytial virus A and human parainfluenza virus type 3 (HPIV3) started earlier, and the epidemics of human metapneumovirus, HPIV1, and influenza A and C viruses resumed as behavioral restrictions for preventing COVID-19 eased. The median age of children with airway infection was significantly higher in the postpandemic group than in the prepandemic group (18.0 months vs. 21.0 months, p < 0.01). The median age of children infected with HPIV3 and human rhinovirus was significantly higher in the postpandemic group than in the prepandemic group.
Conclusions
Strengthening of nonpharmaceutical interventions changed the epidemic dynamics of pediatric infectious diseases, with a trend toward older hospitalized children. Continuous monitoring of pediatric infectious disease outbreaks in hospitalized children can help prepare for the emergence of future viruses and pandemics.
{"title":"Temporal Trends in Respiratory Infection Epidemics Among Pediatric Inpatients Throughout the Course of the COVID-19 Pandemic From 2018 to 2023 in Fukushima Prefecture, Japan","authors":"Yohei Kume, Koichi Hashimoto, Hisao Okabe, Sakurako Norito, Reiko Suwa, Miyuki Kawase, Izumi Mochizuki, Fumi Mashiyama, Naohisa Ishibashi, Shigeo Suzuki, Hiroko Sakuma, Kazuya Shirato, Mitsuaki Hosoya, Hayato Go","doi":"10.1111/irv.70070","DOIUrl":"10.1111/irv.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nonpharmaceutical interventions for coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, during the pandemic altered the epidemiology of respiratory viruses. This study aimed to determine the changes in respiratory viruses among children hospitalized from 2018 to 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nasopharyngeal specimens were collected from children aged under 15 years with fever and/or respiratory symptoms admitted to a medical institution in Fukushima Prefecture between January 2018 and December 2023. Eighteen respiratory viruses were detected using real-time reverse transcription-polymerase chain reaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 1933 patients were included. Viruses were detected in 1377 (71.2%); of these, a single virus was detected in 906 (46.9%) and multiple viruses in 471 (24.3%). Among the viruses whose epidemics were temporarily suppressed, the epidemics of respiratory syncytial virus A and human parainfluenza virus type 3 (HPIV3) started earlier, and the epidemics of human metapneumovirus, HPIV1, and influenza A and C viruses resumed as behavioral restrictions for preventing COVID-19 eased. The median age of children with airway infection was significantly higher in the postpandemic group than in the prepandemic group (18.0 months vs. 21.0 months, <i>p</i> < 0.01). The median age of children infected with HPIV3 and human rhinovirus was significantly higher in the postpandemic group than in the prepandemic group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Strengthening of nonpharmaceutical interventions changed the epidemic dynamics of pediatric infectious diseases, with a trend toward older hospitalized children. Continuous monitoring of pediatric infectious disease outbreaks in hospitalized children can help prepare for the emergence of future viruses and pandemics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacobo Alonso Domínguez, Inés Martínez Barros, Irene Viéitez, Mercedes Peleteiro, Beatriz Calderón-Cruz, José A. González-Nóvoa, Alexandre Pérez González, Virginia Leiro Fernández, Aida López López, Eva Poveda López
Background
The global pandemic caused by SARS-CoV-2 has resulted in millions of people experiencing long COVID condition, a range of persistent symptoms following the acute phase, with an estimated prevalence of 27%–64%.
Materials and Methods
To understand its pathophysiology, we conducted a longitudinal study on viral load and cytokine dynamics in individuals with confirmed SARS-CoV-2 infection. We used reverse transcriptase droplet digital PCR to quantify viral RNA from nasopharyngeal swabs and employed multiplex technology to measure plasma cytokine levels in a cohort of people with SARS-CoV-2 infection. Our study included individuals with long COVID condition and those without, all of whom had at least three nasopharyngeal and plasma samples collected within 55 days after diagnosis of SARS-CoV-2 infection.
Results
Individuals affected with long COVID symptoms had delayed viral clearance and lower viral loads at diagnosis compared to those without symptoms. Additionally, cytokine analysis revealed variations in IL-18, MIG, and IP-10 levels, with delayed normalization in individuals affected by long COVID syndrome. Correlation analysis indicated associations between viral load and IP-10 and interrelations among cytokines IL-1β, IL-18, MIG, and IP-10.
Conclusion
Our study provides insights into the association between nasopharyngeal viral load, cytokine dynamics, and the development of long COVID syndrome, providing an early signature of this condition.
{"title":"SARS-CoV-2 Viral Load and Cytokine Dynamics Profile as Early Signatures of Long COVID Condition in Hospitalized Individuals","authors":"Jacobo Alonso Domínguez, Inés Martínez Barros, Irene Viéitez, Mercedes Peleteiro, Beatriz Calderón-Cruz, José A. González-Nóvoa, Alexandre Pérez González, Virginia Leiro Fernández, Aida López López, Eva Poveda López","doi":"10.1111/irv.70068","DOIUrl":"10.1111/irv.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The global pandemic caused by SARS-CoV-2 has resulted in millions of people experiencing long COVID condition, a range of persistent symptoms following the acute phase, with an estimated prevalence of 27%–64%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>To understand its pathophysiology, we conducted a longitudinal study on viral load and cytokine dynamics in individuals with confirmed SARS-CoV-2 infection. We used reverse transcriptase droplet digital PCR to quantify viral RNA from nasopharyngeal swabs and employed multiplex technology to measure plasma cytokine levels in a cohort of people with SARS-CoV-2 infection. Our study included individuals with long COVID condition and those without, all of whom had at least three nasopharyngeal and plasma samples collected within 55 days after diagnosis of SARS-CoV-2 infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Individuals affected with long COVID symptoms had delayed viral clearance and lower viral loads at diagnosis compared to those without symptoms. Additionally, cytokine analysis revealed variations in IL-18, MIG, and IP-10 levels, with delayed normalization in individuals affected by long COVID syndrome. Correlation analysis indicated associations between viral load and IP-10 and interrelations among cytokines IL-1β, IL-18, MIG, and IP-10.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study provides insights into the association between nasopharyngeal viral load, cytokine dynamics, and the development of long COVID syndrome, providing an early signature of this condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Natalie Wodniak, Radhika Gharpure, Luzhao Feng, Xiaozhan Lai, Hai Fang, Jianmei Tian, Tao Zhang, Genming Zhao, Fernando Salcedo-Mejía, Nelson J. Alvis-Zakzuk, Jorge Jara, Fatimah Dawood, Gideon O. Emukule, Linus K. Ndegwa, I-Ching Sam, Tsogt Mend, Baigalmaa Jantsansengee, Stefano Tempia, Cheryl Cohen, Sibongile Walaza, Wanitchaya Kittikraisak, Arthorn Riewpaiboon, Kathryn E. Lafond, Nelly Mejia, William W. Davis
Background
Seasonal influenza illness and acute respiratory infections can impose a substantial economic burden in low- and middle-income countries (LMICs). We assessed the cost of influenza illness and acute respiratory infections across household income strata.
Methods
We conducted a secondary analysis of data from a prior systematic review of costs of influenza and other respiratory illnesses in LMICs and contacted authors to obtain data on cost of illness (COI) for laboratory-confirmed influenza-like illness and acute respiratory infection. We calculated the COI by household income strata and calculated the out-of-pocket (OOP) cost as a proportion of household income.
Results
We included 11 studies representing 11 LMICs. OOP expenses, as a proportion of annual household income, were highest among the lowest income quintile in 10 of 11 studies: in 4/4 studies among the general population, in 6/7 studies among children, 2/2 studies among older adults, and in the sole study for adults with chronic medical conditions. COI was generally higher for hospitalizations compared with outpatient illnesses; median OOP costs for hospitalizations exceeded 10% of annual household income among the general population and children in Kenya, as well as for older adults and adults with chronic medical conditions in China.
Conclusions
The findings indicate that influenza and acute respiratory infections pose a considerable economic burden, particularly from hospitalizations, on the lowest income households in LMICs. Future evaluations could investigate specific drivers of COI in low-income household and identify interventions that may address these, including exploring household coping mechanisms. Cost-effectiveness analyses could incorporate health inequity analyses, in pursuit of health equity.
{"title":"Costs of Influenza Illness and Acute Respiratory Infections by Household Income Level: Catastrophic Health Expenditures and Implications for Health Equity","authors":"Natalie Wodniak, Radhika Gharpure, Luzhao Feng, Xiaozhan Lai, Hai Fang, Jianmei Tian, Tao Zhang, Genming Zhao, Fernando Salcedo-Mejía, Nelson J. Alvis-Zakzuk, Jorge Jara, Fatimah Dawood, Gideon O. Emukule, Linus K. Ndegwa, I-Ching Sam, Tsogt Mend, Baigalmaa Jantsansengee, Stefano Tempia, Cheryl Cohen, Sibongile Walaza, Wanitchaya Kittikraisak, Arthorn Riewpaiboon, Kathryn E. Lafond, Nelly Mejia, William W. Davis","doi":"10.1111/irv.70059","DOIUrl":"10.1111/irv.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Seasonal influenza illness and acute respiratory infections can impose a substantial economic burden in low- and middle-income countries (LMICs). We assessed the cost of influenza illness and acute respiratory infections across household income strata.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a secondary analysis of data from a prior systematic review of costs of influenza and other respiratory illnesses in LMICs and contacted authors to obtain data on cost of illness (COI) for laboratory-confirmed influenza-like illness and acute respiratory infection. We calculated the COI by household income strata and calculated the out-of-pocket (OOP) cost as a proportion of household income.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 11 studies representing 11 LMICs. OOP expenses, as a proportion of annual household income, were highest among the lowest income quintile in 10 of 11 studies: in 4/4 studies among the general population, in 6/7 studies among children, 2/2 studies among older adults, and in the sole study for adults with chronic medical conditions. COI was generally higher for hospitalizations compared with outpatient illnesses; median OOP costs for hospitalizations exceeded 10% of annual household income among the general population and children in Kenya, as well as for older adults and adults with chronic medical conditions in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings indicate that influenza and acute respiratory infections pose a considerable economic burden, particularly from hospitalizations, on the lowest income households in LMICs. Future evaluations could investigate specific drivers of COI in low-income household and identify interventions that may address these, including exploring household coping mechanisms. Cost-effectiveness analyses could incorporate health inequity analyses, in pursuit of health equity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marco Del Riccio, Andrea Guida, Bronke Boudewijns, Susanne Heemskerk, Jojanneke van Summeren, Caroline Schneeberger, Foekje Stelma, Koos van der Velden, Aura Timen, Saverio Caini
Background
Vaccination is a key measure in influenza control, yet global coverage rates remain low, although previous research reported an increase in influenza vaccination coverage rates (VCR) after the onset of the COVID-19 pandemic. This study aims to assess whether these changes were sustained over time by analyzing VCR trends from 2012 to 2023 in the countries included in the FluCov project.
Methods
Data on influenza VCR from 2012 to 2023 for different age and risk groups were extracted from national health organizations and international sources for countries included in the FluCov project. For coverage rates in the older adults, segmented regression models were used to test if 2020 marked a significant change in VCR trends. Moreover, polynomial regression models were fitted for each country with VCR in the period 2012 to 2020 to predict coverage rates for 2021 to 2023 and to compare these to the actual coverage rates for 2021 to 2023.
Results
For the elderly, we retrieved influenza VCR data for 12 countries. In 2020, VCR among elderly increased in 10 countries, but the increase was statistically significant in Spain and England only. Moreover, all countries except Spain reverted to levels within the confidence intervals of trends modeled using pre-2020 data.
Conclusions
Although influenza VCR increased in 2020, these changes were statistically significant in only two out of 12 countries, and no consistent, sustained increase was observed afterward, except in Spain. The findings suggest the need for continuous monitoring of VCR and the implementation of strategies to promote and maintain high vaccination coverage rates.
{"title":"A Missed Opportunity? Exploring Changes in Influenza Vaccination Coverage During the COVID-19 Pandemic: Data From 12 Countries Worldwide","authors":"Marco Del Riccio, Andrea Guida, Bronke Boudewijns, Susanne Heemskerk, Jojanneke van Summeren, Caroline Schneeberger, Foekje Stelma, Koos van der Velden, Aura Timen, Saverio Caini","doi":"10.1111/irv.70057","DOIUrl":"10.1111/irv.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vaccination is a key measure in influenza control, yet global coverage rates remain low, although previous research reported an increase in influenza vaccination coverage rates (VCR) after the onset of the COVID-19 pandemic. This study aims to assess whether these changes were sustained over time by analyzing VCR trends from 2012 to 2023 in the countries included in the FluCov project.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on influenza VCR from 2012 to 2023 for different age and risk groups were extracted from national health organizations and international sources for countries included in the FluCov project. For coverage rates in the older adults, segmented regression models were used to test if 2020 marked a significant change in VCR trends. Moreover, polynomial regression models were fitted for each country with VCR in the period 2012 to 2020 to predict coverage rates for 2021 to 2023 and to compare these to the actual coverage rates for 2021 to 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For the elderly, we retrieved influenza VCR data for 12 countries. In 2020, VCR among elderly increased in 10 countries, but the increase was statistically significant in Spain and England only. Moreover, all countries except Spain reverted to levels within the confidence intervals of trends modeled using pre-2020 data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although influenza VCR increased in 2020, these changes were statistically significant in only two out of 12 countries, and no consistent, sustained increase was observed afterward, except in Spain. The findings suggest the need for continuous monitoring of VCR and the implementation of strategies to promote and maintain high vaccination coverage rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11710886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yang Liu, Charlie Diamond, Sam Abbott, Kerry Wong, Tanja Schmidt, W. John Edmunds, Richard Pebody, Mark Jit
Background
Between 2020 and 2022, countries used a range of different public health and social measures (PHSMs) to reduce the transmission of SARS-CoV-2. The impact of these PHSMs varied as the pandemic progressed, variants of concern (VOCs) emerged, vaccines rolled out and acceptance/uptake rates evolved. In this study, we assessed the impact of PHSMs in the World Health Organization (WHO) European Region during VOC phases.
Methods
We relied on time series data on genome sequencing, PHSMs, health outcomes and physical contacts. Panel regression models were used to assess the association between PHSMs and SARS-CoV-2 transmission (approximated using time-varying reproduction numbers). The interpretation of these regression models was assisted by hierarchical clustering, which was used to detect the temporal co-occurrence of PHSMs. Generalised linear models were used to check if PHSMs are associated with physical contacts.
Results
We identified four phases based on the dominating VOC in the WHO European Region: wild type (before early 2021), Alpha (early to mid-2021), Delta (mid-to-late 2021) and Omicron (after late 2021). ‘School closure’, ‘stay-at-home requirement’ and ‘testing policy’ were consistently associated with lower transmission across VOC phases. The impact of most PHSMs varied by VOC phases without clear increasing or decreasing trends as the pandemic progressed. Several PHSMs associated with lower transmission were not associated with fewer physical contacts.
Conclusions
The impact of PHSMs evolved as the pandemic progressed—although without clear trends. The specific mechanisms by which some PHSMs reduce SARS-CoV-2 transmission require further research.
{"title":"The Impact of Public Health and Social Measures (PHSMs) on SARS-CoV-2 Transmission in the WHO European Region (2020–2022)","authors":"Yang Liu, Charlie Diamond, Sam Abbott, Kerry Wong, Tanja Schmidt, W. John Edmunds, Richard Pebody, Mark Jit","doi":"10.1111/irv.70036","DOIUrl":"10.1111/irv.70036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Between 2020 and 2022, countries used a range of different public health and social measures (PHSMs) to reduce the transmission of SARS-CoV-2. The impact of these PHSMs varied as the pandemic progressed, variants of concern (VOCs) emerged, vaccines rolled out and acceptance/uptake rates evolved. In this study, we assessed the impact of PHSMs in the World Health Organization (WHO) European Region during VOC phases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We relied on time series data on genome sequencing, PHSMs, health outcomes and physical contacts. Panel regression models were used to assess the association between PHSMs and SARS-CoV-2 transmission (approximated using time-varying reproduction numbers). The interpretation of these regression models was assisted by hierarchical clustering, which was used to detect the temporal co-occurrence of PHSMs. Generalised linear models were used to check if PHSMs are associated with physical contacts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified four phases based on the dominating VOC in the WHO European Region: wild type (before early 2021), Alpha (early to mid-2021), Delta (mid-to-late 2021) and Omicron (after late 2021). ‘School closure’, ‘stay-at-home requirement’ and ‘testing policy’ were consistently associated with lower transmission across VOC phases. The impact of most PHSMs varied by VOC phases without clear increasing or decreasing trends as the pandemic progressed. Several PHSMs associated with lower transmission were not associated with fewer physical contacts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The impact of PHSMs evolved as the pandemic progressed—although without clear trends. The specific mechanisms by which some PHSMs reduce SARS-CoV-2 transmission require further research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"18 12","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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