ABSTRACT
Background. Influenza-associated hospitalization rates were low during the 2020-21 season. We describe influenza-associated hospitalization rates and prevalence of influenza and SARS-CoV-2 coinfection among patients hospitalized with influenza during 2021-22. Methods. We used data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), a population-based surveillance system for laboratoryconfirmed influenza-associated hospitalizations active from October-April of each year. We calculated cumulative and weekly hospitalization rates per 100,000 population and compared preliminary rates during 2021-22 with prior season rates (2010-11 through 2020-21). We determined the proportion of influenza-associated hospitalizations with SARS-CoV-2 coinfection during 2021-22. Results. During October 1, 2021-April 23, 2022, 3,262 influenza-associated hospitalizations were reported to FluSurv-NET;the cumulative hospitalization rate of 11.1 was higher than 2011-12 and 2020-21 season rates, but lower than rates observed during all other seasons since 2010-11 (Figure 1A). After peaking in the week ending January 1, 2022 (MMWR week 52), weekly hospitalization rates declined until the week ending February 19, 2022 (MMWR week 7) when they began to rise modestly, similar to patterns observed during several prior seasons (Figure 1B). Among the 3,262 hospitalizations, 87 (2.7%) had SARS-CoV-2 coinfection;the prevalence by age group was as follows: 0-17 years 3.4%, 18-49 years 2.8%, 50-64 years 3.5%, 65-74 years 2.5%, >= 75 years 1.6%. Among the 3,262 influenza-associated hospitalizations, the prevalence of SARS-CoV-2 coinfection by month (October 2021- April 2022), respectively, was 11.4%, 2.5%, 2.6%, 8.9%, 3.4%, 0.8%, and 0.5%. Conclusion. SARS-CoV-2 coinfection was uncommon among patients hospitalized with influenza during 2021-22. Likely due to ongoing COVID-19 mitigation measures, the influenza-associated hospitalization rate during 2021-22 was lower than rates observed in most seasons in the decade preceding the COVID-19 pandemic. A late rise in weekly influenza hospitalization rates in 2021-22 might have been a result of relaxation of COVID-19 mitigation measures and/or a late season peak in influenza activity. (Figure Presented).
ABSTRACT
Background and Purpose: The novel coronavirus of 2019 (COVID-19) has been associated with worse outcomes for hospitalized patients across the US and worldwide. Our study investigates the effect of the pandemic on functional outcomes for patients presenting with stroke-like symptoms in two high-volume Tele-Stroke networks. Methods: We performed retrospective chart review of 7689 consecutive patients seen through two Tele-Stroke networks (Medical University of South Carolina and Augusta University) from July 2019 through May 2020. Discharge outcomes were assessed using modified Rankin scale (mRS). We dichotomized patients to preCOVID-19 pandemic (July 2019 to February 2020) and during COVID- 19 pandemic (March to May 2020). Results: During COVID, a higher percentage of patients received intravenous tissue plasminogen activator (tPA) (14.2% vs 11.3% before, p=0.001), despite a similar baseline NIHSS. Also, patients during the pandemic had a shorter symptom-onset to hospital door time (288 vs 353, P=0.012). Demographics were similar between groups, other than older age in patients presenting during COVID (66.02 vs 65.15 before, p=0.04) (table 1). During the pandemic, a higher percentage of patients had a poor functional outcome, as defined by mRS 3-6 (35.7% vs 30% before, p=0.012), and a higher percentage died or were discharged to hospice (7.0% vs 5.1%, p=0.000). Conclusions: Despite earlier ED presentation and increased tPA administration, our results demonstrate worse discharge outcomes during the pandemic in two large telestroke networks. Changes in workflow and resulting delays during COVID-19 may explain these findings.