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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
IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-02-05 DOI: 10.1111/irv.70069
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.

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引用次数: 0
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
IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-02-02 DOI: 10.1111/irv.70074
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.

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引用次数: 0
Rethinking Optimal Immunogens to Face SARS-CoV-2 Evolution Through Vaccination
IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-28 DOI: 10.1111/irv.70076
Julià Blanco, Benjamin Trinité, Joan Puig-Barberà

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.

SARS-CoV-2 于 2019 年底起源于中国,迅速引发了全球 COVID-19 大流行,对全世界的健康和经济产生了深远影响。一系列疫苗(大多基于完整的 SARS-CoV-2 Spike 蛋白)被迅速开发出来,显示出极佳的体液和细胞反应,对无症状感染和严重疾病都有很高的疗效。然而,病毒的演变和体液中和反应的减弱对疫苗的长期有效性(主要是对无症状感染的有效性)提出了严峻的挑战,因此有必要采取重复和更新加强注射的策略。在这种反复接种疫苗的情况下,抗体复合物出现了多样化,但加强剂量或再感染后的免疫印记也得到了证实,并被确定为对反复接触抗原产生免疫反应的一个主要决定因素。考虑到 SARS-CoV-2 Spike 蛋白的一个小结构域--受体结合结构域(RBD)--是中和抗体的主要靶点,并集中了大多数病毒变异,下文旨在就目前有关疫苗强化剂最佳策略的争论提供见解。我们探讨了针对不断演变的 RBD 开发新强化疫苗的意义,从而将重点放在 SARS-CoV-2 新变种的相关抗原位点上。将这一策略与免疫融合和计算机化方法相结合,可以最大限度地减少免疫印记,从而优化中和免疫反应和强化疫苗的功效。
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引用次数: 0
Assessing the Impact of Non-Pharmaceutical Interventions During the COVID-19 Pandemic on RSV Seasonality in Europe 评估COVID-19大流行期间非药物干预措施对欧洲RSV季节性的影响
IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-21 DOI: 10.1111/irv.70066
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.

背景:在2019冠状病毒病大流行期间,出现了非典型呼吸道合胞病毒(RSV)的传播模式,RSV活动在典型冬季之外发生。本研究调查了COVID-19和相关的非药物干预措施(npi)对RSV季节性的影响。方法:采用3%阳性阈值法测定欧洲12个国家2018 - 2022年RSV流行的发病、偏移和高峰。利用RSV监测数据、两个NPI数据库(ECDC-JRC和Oxford)和COVID-19监测数据,一个多层纵向logit比例回归模型评估了五个NPI(学校关闭、口罩使用、工作场所措施、公共集会限制和公共场所关闭)与RSV之间的关联。结果:2020年之前RSV季节性特征基本一致,但2020-2022年冬季RSV阳性病例未出现季节性增加。分析显示个体npi与RSV之间的关联不一致。根据所使用的数据源(ECDC-JRC或Oxford),关联有所不同,不仅在量级上,而且在系数的方向上。限制公共集会和关闭公共场所与RSV发病率呈显著负相关。然而,这只是在使用整个流行病学年度的监测数据时才观察到的,而不是在仅检查RSV活动增加的周时观察到的。结论:本研究强调需要标准化的国际数据收集和传染病建模程序,因为各国不同的新感染pi实施、新感染pi登记和RSV监测使对大流行期间RSV动态的理解复杂化。在解释npi对呼吸道合胞病毒循环的影响时,建议谨慎。
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引用次数: 0
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 波斯尼亚和黑塞哥维那塞族共和国第二轮基于人群的抗sars - cov -2抗体血清阳性率研究和COVID-19疫苗接种评估
IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-16 DOI: 10.1111/irv.70053
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,&nbsp;Biljana Mijović,&nbsp;Srđan Mašić,&nbsp;Miroslav Petković,&nbsp;Dragana Puhalo Sladoje,&nbsp;Darija Knežević,&nbsp;Jelena Đaković Dević,&nbsp;Dragan Spaić,&nbsp;Jelena Vladičić-Mašić,&nbsp;Dejan Bokonjić,&nbsp;Mirza Palo,&nbsp;Aisling Vaughan,&nbsp;Richard Pebody,&nbsp;Anthony Nardone,&nbsp;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}
引用次数: 0
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 2018 - 2023年日本福岛县新冠肺炎大流行期间儿科住院患者呼吸道感染流行的时间趋势
IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-12 DOI: 10.1111/irv.70070
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

Background

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.

背景:由严重急性呼吸道综合征冠状病毒 2 引起的冠状病毒病(COVID-19)大流行期间的非药物干预改变了呼吸道病毒的流行病学。本研究旨在确定2018年至2023年住院儿童中呼吸道病毒的变化情况。方法:从 2018 年 1 月至 2023 年 12 月期间,从福岛县医疗机构收治的有发热和/或呼吸道症状的 15 岁以下儿童中采集鼻咽部标本。使用实时反转录聚合酶链反应检测了 18 种呼吸道病毒:结果:共纳入 1933 名患者。1377人(71.2%)检测到病毒,其中906人(46.9%)检测到单一病毒,471人(24.3%)检测到多种病毒。在流行暂时被抑制的病毒中,甲型呼吸道合胞病毒和人副流感病毒 3 型(HPIV3)的流行开始较早,而人偏肺病毒、HPIV1 以及甲型和丙型流感病毒的流行则随着预防 COVID-19 的行为限制的放松而恢复。流行后组气道感染儿童的中位年龄明显高于流行前组(18.0 个月对 21.0 个月,P 结论:流行后组气道感染儿童的中位年龄明显高于流行前组(18.0 个月对 21.0 个月,P 结论:流行后组气道感染儿童的中位年龄明显高于流行前组):加强非药物干预措施改变了儿科传染病的流行态势,住院患儿的年龄呈增大趋势。持续监测住院儿童中爆发的儿科传染病有助于为未来病毒和流行病的出现做好准备。
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引用次数: 0
SARS-CoV-2 Viral Load and Cytokine Dynamics Profile as Early Signatures of Long COVID Condition in Hospitalized Individuals SARS-CoV-2病毒载量和细胞因子动力学特征是住院患者长期COVID状态的早期特征
IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-12 DOI: 10.1111/irv.70068
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.

背景:由 SARS-CoV-2 引起的全球大流行导致数百万人出现长期的 COVID 症状,这是急性期后的一系列持续性症状,估计发病率为 27%-64%:为了解其病理生理学,我们对确诊 SARS-CoV-2 感染者的病毒载量和细胞因子动态进行了纵向研究。我们采用逆转录酶液滴数字 PCR 技术对鼻咽拭子中的病毒 RNA 进行定量,并采用多重技术对一组 SARS-CoV-2 感染者的血浆细胞因子水平进行测量。我们的研究包括有长期 COVID 症状和无 COVID 症状的患者,他们都在确诊感染 SARS-CoV-2 后 55 天内采集了至少三次鼻咽和血浆样本:结果:与无症状者相比,有长期 COVID 症状者的病毒清除延迟,确诊时病毒载量较低。此外,细胞因子分析显示,IL-18、MIG 和 IP-10 水平存在差异,长 COVID 综合征患者的正常化延迟。相关分析表明,病毒载量与 IP-10 之间存在关联,细胞因子 IL-1β、IL-18、MIG 和 IP-10 之间也存在相互关系:我们的研究深入揭示了鼻咽病毒载量、细胞因子动态与长 COVID 综合征发展之间的关联,为该疾病提供了早期特征。
{"title":"SARS-CoV-2 Viral Load and Cytokine Dynamics Profile as Early Signatures of Long COVID Condition in Hospitalized Individuals","authors":"Jacobo Alonso Domínguez,&nbsp;Inés Martínez Barros,&nbsp;Irene Viéitez,&nbsp;Mercedes Peleteiro,&nbsp;Beatriz Calderón-Cruz,&nbsp;José A. González-Nóvoa,&nbsp;Alexandre Pérez González,&nbsp;Virginia Leiro Fernández,&nbsp;Aida López López,&nbsp;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}
引用次数: 0
Costs of Influenza Illness and Acute Respiratory Infections by Household Income Level: Catastrophic Health Expenditures and Implications for Health Equity 按家庭收入水平划分的流感疾病和急性呼吸道感染成本:灾难性卫生支出及其对卫生公平的影响。
IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-09 DOI: 10.1111/irv.70059
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.

背景:季节性流感疾病和急性呼吸道感染可给低收入和中等收入国家(LMICs)带来沉重的经济负担。我们评估了不同家庭收入阶层的流感疾病和急性呼吸道感染的成本。方法:我们对先前关于中低收入国家流感和其他呼吸道疾病成本的系统综述数据进行了二次分析,并联系了作者,以获取实验室确诊的流感样疾病和急性呼吸道感染的疾病成本(COI)数据。我们按家庭收入阶层计算了COI,并计算了自费(OOP)成本占家庭收入的比例。结果:我们纳入了代表11个中低收入国家的11项研究。在11项研究中的10项中,最低收入五分之一人群的OOP费用占家庭年收入的比例最高:在4/4的普通人群研究中,在6/7的儿童研究中,在2/2的老年人研究中,在唯一一项针对患有慢性疾病的成年人的研究中。与门诊疾病相比,住院疾病的COI普遍较高;肯尼亚普通人群和儿童以及中国老年人和慢性病患者的住院费用中位数超过家庭年收入的10%。结论:研究结果表明,流感和急性呼吸道感染对中低收入国家的最低收入家庭造成了相当大的经济负担,特别是住院治疗。未来的评估可以调查低收入家庭COI的具体驱动因素,并确定可能解决这些问题的干预措施,包括探索家庭应对机制。成本效益分析可纳入卫生不平等分析,以追求卫生公平。
{"title":"Costs of Influenza Illness and Acute Respiratory Infections by Household Income Level: Catastrophic Health Expenditures and Implications for Health Equity","authors":"Natalie Wodniak,&nbsp;Radhika Gharpure,&nbsp;Luzhao Feng,&nbsp;Xiaozhan Lai,&nbsp;Hai Fang,&nbsp;Jianmei Tian,&nbsp;Tao Zhang,&nbsp;Genming Zhao,&nbsp;Fernando Salcedo-Mejía,&nbsp;Nelson J. Alvis-Zakzuk,&nbsp;Jorge Jara,&nbsp;Fatimah Dawood,&nbsp;Gideon O. Emukule,&nbsp;Linus K. Ndegwa,&nbsp;I-Ching Sam,&nbsp;Tsogt Mend,&nbsp;Baigalmaa Jantsansengee,&nbsp;Stefano Tempia,&nbsp;Cheryl Cohen,&nbsp;Sibongile Walaza,&nbsp;Wanitchaya Kittikraisak,&nbsp;Arthorn Riewpaiboon,&nbsp;Kathryn E. Lafond,&nbsp;Nelly Mejia,&nbsp;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}
引用次数: 0
A Missed Opportunity? Exploring Changes in Influenza Vaccination Coverage During the COVID-19 Pandemic: Data From 12 Countries Worldwide 错失良机?探索COVID-19大流行期间流感疫苗接种覆盖率的变化:来自全球12个国家的数据
IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-01-08 DOI: 10.1111/irv.70057
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.

背景:疫苗接种是控制流感的一项关键措施,但全球疫苗接种覆盖率仍然很低,尽管先前的研究报告称,在COVID-19大流行发生后,流感疫苗接种覆盖率(VCR)有所增加。本研究旨在通过分析fluov项目所包括的国家从2012年到2023年的VCR趋势来评估这些变化是否持续。方法:从fluov项目纳入国家的国家卫生组织和国际来源中提取2012 - 2023年不同年龄和危险人群的流感VCR数据。对于老年人的覆盖率,使用分段回归模型来测试2020年是否标志着VCR趋势的显著变化。此外,对2012年至2020年期间VCR的每个国家进行了多项式回归模型拟合,以预测2021年至2023年的覆盖率,并将其与2021年至2023年的实际覆盖率进行比较。结果:对于老年人,我们检索了12个国家的流感VCR数据。2020年,10个国家的老年人VCR增加,但只有西班牙和英国的增长具有统计学意义。此外,除西班牙外,所有国家都恢复到使用2020年前数据建模的趋势置信区间内的水平。结论:尽管流感VCR在2020年有所增加,但这些变化在12个国家中仅在两个国家具有统计学意义,并且除了西班牙之外,此后没有观察到持续的增长。研究结果表明,需要持续监测VCR,并实施促进和维持高疫苗接种率的战略。
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引用次数: 0
The Impact of Public Health and Social Measures (PHSMs) on SARS-CoV-2 Transmission in the WHO European Region (2020–2022) 公共卫生和社会措施对世卫组织欧洲区域SARS-CoV-2传播的影响(2020-2022年)
IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-12-26 DOI: 10.1111/irv.70036
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.

背景:在2020年至2022年期间,各国采取了一系列不同的公共卫生和社会措施来减少SARS-CoV-2的传播。这些phsm的影响随着大流行的进展、关注变体(VOCs)的出现、疫苗的推出以及接受/吸收率的变化而变化。在本研究中,我们评估了世界卫生组织(WHO)欧洲地区在VOC阶段的phsm的影响。方法:我们依赖于基因组测序、体质健康指数、健康结果和身体接触的时间序列数据。使用面板回归模型评估phsm与SARS-CoV-2传播之间的关系(使用时变复制数进行近似)。这些回归模型的解释由层次聚类辅助,用于检测phsm的时间共现性。使用广义线性模型来检查phsm是否与物理接触相关联。结果:我们根据世卫组织欧洲地区主要挥发性有机化合物确定了四个阶段:野生型(2021年初之前)、Alpha型(2021年初至中期)、Delta型(2021年中至后期)和Omicron型(2021年底之后)。“学校关闭”、“居家要求”和“测试政策”始终与VOC在各个阶段的低传播有关。大多数phsm的影响随挥发性有机化合物的不同阶段而变化,随着大流行的进展没有明显的增加或减少趋势。一些与低传播相关的phsm与较少的物理接触无关。结论:phsm的影响随着大流行的发展而演变,尽管没有明确的趋势。一些phsm减少SARS-CoV-2传播的具体机制需要进一步研究。
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引用次数: 0
期刊
Influenza and Other Respiratory Viruses
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