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1.
Euro Surveill ; 27(1)2022 01.
Article in English | MEDLINE | ID: covidwho-1613508

ABSTRACT

BackgroundSince the onset of the COVID-19 pandemic, the disease has frequently been compared with seasonal influenza, but this comparison is based on little empirical data.AimThis study compares in-hospital outcomes for patients with community-acquired COVID-19 and patients with community-acquired influenza in Switzerland.MethodsThis retrospective multi-centre cohort study includes patients > 18 years admitted for COVID-19 or influenza A/B infection determined by RT-PCR. Primary and secondary outcomes were in-hospital mortality and intensive care unit (ICU) admission for patients with COVID-19 or influenza. We used Cox regression (cause-specific and Fine-Gray subdistribution hazard models) to account for time-dependency and competing events with inverse probability weighting to adjust for confounders.ResultsIn 2020, 2,843 patients with COVID-19 from 14 centres were included. Between 2018 and 2020, 1,381 patients with influenza from seven centres were included; 1,722 (61%) of the patients with COVID-19 and 666 (48%) of the patients with influenza were male (p < 0.001). The patients with COVID-19 were younger (median 67 years; interquartile range (IQR): 54-78) than the patients with influenza (median 74 years; IQR: 61-84) (p < 0.001). A larger percentage of patients with COVID-19 (12.8%) than patients with influenza (4.4%) died in hospital (p < 0.001). The final adjusted subdistribution hazard ratio for mortality was 3.01 (95% CI: 2.22-4.09; p < 0.001) for COVID-19 compared with influenza and 2.44 (95% CI: 2.00-3.00, p < 0.001) for ICU admission.ConclusionCommunity-acquired COVID-19 was associated with worse outcomes compared with community-acquired influenza, as the hazards of ICU admission and in-hospital death were about two-fold to three-fold higher.


Subject(s)
COVID-19 , Influenza, Human , Cohort Studies , Hospital Mortality , Hospitalization , Hospitals , Humans , Influenza, Human/diagnosis , Influenza, Human/epidemiology , Intensive Care Units , Male , Pandemics , Retrospective Studies , SARS-CoV-2 , Switzerland/epidemiology
2.
Eur J Neurol ; 28(10): 3411-3417, 2021 10.
Article in English | MEDLINE | ID: covidwho-1607226

ABSTRACT

BACKGROUND AND PURPOSE: Since the outbreak of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, several reports indicated neurological involvement in COVID-19 disease. Muscle involvement has also been reported as evidenced by creatine kinase (CK) elevations and reports of myalgia. METHODS: Creatine kinase, markers of inflammation, pre-existing diseases and statin use were extracted from records of Austrian hospitalised COVID-19 patients. Disease severity was classified as severe in case of intensive care unit (ICU) admission or mortality. COVID-19 patients were additionally compared to an historical group of hospitalised influenza patients. RESULTS: Three hundred fifty-one patients with SARS-CoV-2 and 258 with influenza were included in the final analysis. CK was elevated in 27% of COVID-19 and in 28% of influenza patients. CK was higher in severe COVID-19 as were markers of inflammation. CK correlated significantly with inflammation markers, which had an independent impact on CK when adjusted for demographic variables and disease severity. Compared to influenza patients, COVID-19 patients were older, more frequently male, had more comorbidities, and more frequently had a severe disease course. Nevertheless, influenza patients had higher baseline CK than COVID-19, and 35.7% of intensive care unit (ICU)-admitted patients had CK levels >1,000 U/L compared to only 4.7% of ICU-admitted COVID-19 patients. CONCLUSIONS: HyperCKemia occurs in a similar frequency in COVID-19 and influenza infection. CK levels were lower in COVID-19 than in influenza in mild and severe disease. CK levels strongly correlate with disease severity and markers of inflammation. To date, it remains unclear whether hyperCKemia is due to a virus-triggered inflammatory response or direct muscle toxicity.


Subject(s)
COVID-19 , Influenza, Human , Humans , Influenza, Human/complications , Influenza, Human/epidemiology , Male , Muscles , Pandemics , SARS-CoV-2
3.
Crit Care ; 26(1): 11, 2022 01 04.
Article in English | MEDLINE | ID: covidwho-1607559

ABSTRACT

BACKGROUND: Recent multicenter studies identified COVID-19 as a risk factor for invasive pulmonary aspergillosis (IPA). However, no large multicenter study has compared the incidence of IPA between COVID-19 and influenza patients. OBJECTIVES: To determine the incidence of putative IPA in critically ill SARS-CoV-2 patients, compared with influenza patients. METHODS: This study was a planned ancillary analysis of the coVAPid multicenter retrospective European cohort. Consecutive adult patients requiring invasive mechanical ventilation for > 48 h for SARS-CoV-2 pneumonia or influenza pneumonia were included. The 28-day cumulative incidence of putative IPA, based on Blot definition, was the primary outcome. IPA incidence was estimated using the Kalbfleisch and Prentice method, considering extubation (dead or alive) within 28 days as competing event. RESULTS: A total of 1047 patients were included (566 in the SARS-CoV-2 group and 481 in the influenza group). The incidence of putative IPA was lower in SARS-CoV-2 pneumonia group (14, 2.5%) than in influenza pneumonia group (29, 6%), adjusted cause-specific hazard ratio (cHR) 3.29 (95% CI 1.53-7.02, p = 0.0006). When putative IPA and Aspergillus respiratory tract colonization were combined, the incidence was also significantly lower in the SARS-CoV-2 group, as compared to influenza group (4.1% vs. 10.2%), adjusted cHR 3.21 (95% CI 1.88-5.46, p < 0.0001). In the whole study population, putative IPA was associated with significant increase in 28-day mortality rate, and length of ICU stay, compared with colonized patients, or those with no IPA or Aspergillus colonization. CONCLUSIONS: Overall, the incidence of putative IPA was low. Its incidence was significantly lower in patients with SARS-CoV-2 pneumonia than in those with influenza pneumonia. Clinical trial registration The study was registered at ClinicalTrials.gov, number NCT04359693 .


Subject(s)
COVID-19 , Influenza, Human , Intubation , Invasive Pulmonary Aspergillosis , Adult , COVID-19/epidemiology , COVID-19/therapy , Europe/epidemiology , Humans , Incidence , Influenza, Human/epidemiology , Influenza, Human/therapy , Invasive Pulmonary Aspergillosis/epidemiology , Retrospective Studies , SARS-CoV-2
4.
Biochemistry (Mosc) ; 86(7): 800-817, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1594970

ABSTRACT

COVID-19, a new human respiratory disease that has killed nearly 3 million people in a year since the start of the pandemic, is a global public health challenge. Its infectious agent, SARS-CoV-2, differs from other coronaviruses in a number of structural features that make this virus more pathogenic and transmissible. In this review, we discuss some important characteristics of the main SARS-CoV-2 surface antigen, the spike (S) protein, such as (i) ability of the receptor-binding domain (RBD) to switch between the "standing-up" position (open pre-fusion conformation) for receptor binding and the "lying-down" position (closed pre-fusion conformation) for immune system evasion; (ii) advantage of a high binding affinity of the RBD open conformation to the human angiotensin-converting enzyme 2 (ACE2) receptor for efficient cell entry; and (iii) S protein preliminary activation by the intracellular furin-like proteases for facilitation of the virus spreading across different cell types. We describe interactions between the S protein and cellular receptors, co-receptors, and antagonists, as well as a hypothetical mechanism of the homotrimeric spike structure destabilization that triggers the fusion of the viral envelope with the cell membrane at physiological pH and mediates the viral nucleocapsid entry into the cytoplasm. The transition of the S protein pre-fusion conformation to the post-fusion one on the surface of virions after their treatment with some reagents, such as ß-propiolactone, is essential, especially in relation to the vaccine production. We also compare the COVID-19 pathogenesis with that of severe outbreaks of "avian" influenza caused by the A/H5 and A/H7 highly pathogenic viruses and discuss the structural similarities between the SARS-CoV-2 S protein and hemagglutinins of those highly pathogenic strains. Finally, we touch on the prospective and currently used COVID-19 antiviral and anti-pathogenetic therapeutics, as well as recently approved conventional and innovative COVID-19 vaccines and their molecular and immunological features.


Subject(s)
Angiotensin-Converting Enzyme 2 , COVID-19 , Pandemics , SARS-CoV-2 , Spike Glycoprotein, Coronavirus , Angiotensin-Converting Enzyme 2/chemistry , Angiotensin-Converting Enzyme 2/genetics , Angiotensin-Converting Enzyme 2/metabolism , COVID-19/epidemiology , COVID-19/genetics , COVID-19/metabolism , Humans , Influenza A virus/chemistry , Influenza A virus/genetics , Influenza A virus/metabolism , Influenza, Human/epidemiology , Influenza, Human/genetics , Influenza, Human/metabolism , SARS-CoV-2/chemistry , SARS-CoV-2/genetics , SARS-CoV-2/metabolism , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/metabolism
5.
Front Public Health ; 9: 773130, 2021.
Article in English | MEDLINE | ID: covidwho-1593754

ABSTRACT

Background: Although coinfection with influenza in COVID-19 patients has drawn considerable attention, it is still not completely understood whether simultaneously infected with these two viruses influences disease severity. We therefore aimed to estimate the impact of coinfected with SARS-CoV-2 and influenza on the disease outcomes compared with the single infection of SARS-CoV-2. Materials and Methods: We searched the PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure Database (CNKI) to identify relevant articles up to July 9, 2021. Studies that assessed the effect of SARS-CoV-2 and influenza coinfection on disease outcomes or those with sufficient data to calculate risk factors were included. Risk effects were pooled using fixed or random effects model. Results: We ultimately identified 12 studies with 9,498 patients to evaluate the risk effects of SARS-CoV-2 and influenza coinfection on disease severity. Results indicated that coinfection was not significantly associated with mortality (OR = 0.85, 95%CI: 0.51, 1.43; p = 0.55, I 2 = 76.00%). However, mortality was found significantly decreased in the studies from China (OR = 0.51, 95%CI: 0.39, 0.68; I 2 = 26.50%), while significantly increased outside China (OR = 1.56, 95%CI: 1.12, 2.19; I 2 = 1.00%). Moreover, a lower risk for critical outcomes was detected among coinfection patients (OR = 0.64, 95%CI: 0.43, 0.97; p = 0.04, I 2 = 0.00%). Additionally, coinfection patients presented different laboratory indexes compared with the single SARS-CoV-2 infection, including lymphocyte counts and APTT. Conclusion: Our study revealed that coinfection with SARS-CoV-2 and influenza had no effect on overall mortality. However, risk for critical outcomes was lower in coinfection patients and different associations were detected in the studies from different regions and specific laboratory indexes. Further studies on influenza strains and the order of infection were warranted. Systematic testing for influenza coinfection in COVID-19 patients and influenza vaccination should be recommended.


Subject(s)
COVID-19 , Coinfection , Influenza, Human , Humans , Influenza, Human/complications , Influenza, Human/epidemiology , SARS-CoV-2 , Severity of Illness Index
7.
Euro Surveill ; 26(27)2021 07.
Article in English | MEDLINE | ID: covidwho-1577032

ABSTRACT

BackgroundInfluenza virus presents a considerable challenge to public health by causing seasonal epidemics and occasional pandemics. Nanopore metagenomic sequencing has the potential to be deployed for near-patient testing, providing rapid infection diagnosis, rationalising antimicrobial therapy, and supporting infection-control interventions.AimTo evaluate the applicability of this sequencing approach as a routine laboratory test for influenza in clinical settings.MethodsWe conducted Oxford Nanopore Technologies (Oxford, United Kingdom (UK)) metagenomic sequencing for 180 respiratory samples from a UK hospital during the 2018/19 influenza season, and compared results to routine molecular diagnostic standards (Xpert Xpress Flu/RSV assay; BioFire FilmArray Respiratory Panel 2 assay). We investigated drug resistance, genetic diversity, and nosocomial transmission using influenza sequence data.ResultsCompared to standard testing, Nanopore metagenomic sequencing was 83% (75/90) sensitive and 93% (84/90) specific for detecting influenza A viruses. Of 59 samples with haemagglutinin subtype determined, 40 were H1 and 19 H3. We identified an influenza A(H3N2) genome encoding the oseltamivir resistance S331R mutation in neuraminidase, potentially associated with an emerging distinct intra-subtype reassortant. Whole genome phylogeny refuted suspicions of a transmission cluster in a ward, but identified two other clusters that likely reflected nosocomial transmission, associated with a predominant community-circulating strain. We also detected other potentially pathogenic viruses and bacteria from the metagenome.ConclusionNanopore metagenomic sequencing can detect the emergence of novel variants and drug resistance, providing timely insights into antimicrobial stewardship and vaccine design. Full genome generation can help investigate and manage nosocomial outbreaks.


Subject(s)
Cross Infection , Influenza, Human , Nanopores , Antiviral Agents/therapeutic use , Cross Infection/diagnosis , Cross Infection/drug therapy , Drug Resistance , Drug Resistance, Viral/genetics , Humans , Influenza A Virus, H3N2 Subtype/genetics , Influenza, Human/diagnosis , Influenza, Human/drug therapy , Influenza, Human/epidemiology , Metagenome , Neuraminidase/genetics , Seasons , United Kingdom
8.
Int J Chron Obstruct Pulmon Dis ; 16: 3337-3346, 2021.
Article in English | MEDLINE | ID: covidwho-1581602

ABSTRACT

Background: SARS-CoV-2 tends to cause more severe disease in patients with COPD once they are infected. We aimed to investigate the rates of influenza, pneumococcal and COVID-19 vaccination uptake in patients with COPD and to determine whether the COVID-19 pandemic and widespread vaccination against COVID-19 had any impact on the intention to accept influenza vaccines in these patients. Methods: We conducted a multi-center and cross-sectional survey in seven tertiary hospitals in Beijing and consecutively recruited outpatients with COPD from June 1st to July 30th, 2021. The survey included patient's clinical characteristics, uptake of influenza, pneumococcal and COVID-19 vaccination, vaccine knowledge, attitude towards vaccines, and the change of intention to receive influenza vaccination after COVID-19 epidemic and COVID-19 vaccination in Beijing. Results: A total of 264 patients were enrolled. The rate of COVID-19 vaccination during the study period was 39.0%. The rates of influenza vaccination in the past season and pneumococcal vaccination in the past year were 22.7% and 5.7%, respectively. Of the patients who had not received COVID-19 vaccination (n = 161), only 16.2% reported that COVID-19 vaccination was recommended by clinicians, while 23.5% had no knowledge regarding COVID-19 vaccination. About 51.1% of the patients reported that their intention to receive influenza vaccination was influenced by the COVID-19 pandemic. COVID-19 vaccination was independently associated with a positive change in intention to receive influenza vaccination. Conclusion: The coverage rate of COVID-19 vaccination among patients with COPD in Beijing was 39.0%, and that of influenza and pneumococcal vaccination was very low. The COVID-19 pandemic and the COVID-19 vaccination campaign showed a significant, positive impact on patients with COPD in terms of influenza vaccination. Improving awareness of the effectiveness and safety of vaccines among both healthcare professionals and patients could increase vaccination coverage in patients with COPD.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Pulmonary Disease, Chronic Obstructive , COVID-19 Vaccines , Cross-Sectional Studies , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Intention , Pandemics , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , SARS-CoV-2 , Vaccination
9.
Tuberk Toraks ; 69(4): 458-468, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1580011

ABSTRACT

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causing a global pandemic starting from December 2019, showed a course that resulted in serious mortality in the world. In order to understand SARSCoV-2 better, here we aimed to compare the similar and different characteristics of Influenza viruses occurring in the same season with SARS-CoV-2. Materials and Methods: A total of 144 patients (31 patients with COVID-19, 62 patients with H1N1 influenza, and 51 patients with influenza B) were included in the study. Demographic findings, chronic diseases, laboratory values, chest x-ray, and chest CT findings of the patients were evaluated retrospectively. Result: Median age of the COVID-19 patients and rate of male patients were higher than other patient groups (55 years; p< 0.001) (61% male; p< 0.001). The most common chronic medical conditions were hypertension and diabetes. Platelet numbers and alanine aminotransferase values were significantly higher in COVID-19 patients. Radiologically, bilateral (74.2%) and nonspecific distribution (58.1%), ground-glass opacities with consolidation (51.6%), patchy image (25.8%), ground-glass opacities with interstitial changes (22.6%) and halo sign (22.6%) were quite evident than other groups in COVID-19 patients (p< 0.05). Conclusions: We suggest that due to the higher PLT values observed in COVID-19 patients, initiation of anticoagulant therapy should be considered in the early stage and routine follow-up with d-dimer and fibrinogen should be applied for suspected patients. Moreover, attention should be paid in terms of possible liver toxicity of the drugs to be used in treatment due the higher ALT values observed in COVID-19 patients. Since we did not detect SARS-CoV-2 and influenza viruses concurrently in the same patient, it may be helpful to focus on only one virus in a patient with symptoms, and radiographic differences can be used to differentiate COVID-19 from influenza.


Subject(s)
COVID-19 , Influenza A Virus, H1N1 Subtype , Influenza, Human , Female , Humans , Influenza, Human/epidemiology , Male , Middle Aged , Retrospective Studies , SARS-CoV-2
10.
J Prev Med Hyg ; 62(3): E613-E620, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1575621

ABSTRACT

The intrusion of infectious diseases in everyday life forces humans to reassess their attitudes. Indeed, pandemics are able catalyze rapid transitions in scientific knowledge, politics, social behaviors, culture and arts. The current Coronavirus diesease-19 (COVID-19) outbreak has driven an unprecedented interest toward the influenza pandemic of 1918. The issue is whether history can shed light on the best preventive response and future scenarios. The aim of this review is to highlight the parallelism between the two pandemics. Starting from epidemiology and clinical features, but further focusing on social and cultural issues, it is possible to unreveal great similarities. Their outbreak pattern lead to hypothesize a similar duration and death burden in absence of effective vaccines or innovative treatments for COVID-19. Thus, then as now, preventive medicine represents the first and most effective tool to contain the course of the pandemic; being treatments available only supportive. At the same time,both pandemics shared the same pattern of narration (e.g. scapegoating) and the same impact on minorities in high-income countries. Furthermore, visual art responded to pandemic issues in 2020 in the form of Graffiti art, while similar role was ruled by Expressionism movement during the Spanish flu. Photography also was capable to document both catastrophic scenarios. Thus, it is possible to find a lot of clinical and social similarities between the two pandemics. Nevertheless, if the Spanish flu was not unforseen, COVID-19 spillover was partially predictable and its global impact will hopefully not be overshadowed by a major crisis such as World War I.


Subject(s)
COVID-19 , Influenza Pandemic, 1918-1919 , Influenza, Human , Female , History, 20th Century , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Pandemics/prevention & control , Pregnancy , SARS-CoV-2
11.
J Prev Med Hyg ; 62(3): E586-E591, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1575500

ABSTRACT

Introduction: The aim of the current study was to assess if the frequency of internet searches for influenza are aligned with Italian National Institute of Health (ISS) cases and deaths. Also, we evaluate the distribution over time and the correlation between search volume of flu and flu symptoms with reported new cases of SARS-CoV-2. Materials and methods: The reported cases and deaths of flu and the reported cases of SARS-CoV-2 were selected from the reports of ISS, the data have been aggregated by week. The search volume provided by Google Trends (GT) has a relative nature and is calculated as a percentage of query related to a specific term in connection with a determined place and time-frame. Results: The strongest correlation between GT search and influenza cases was found at a lag of +1 week particularly for the period 2015-2019. A strong correlation was also found at a lag of +1 week between influenza death and GT search. About the correlation between GT search and SARS-CoV-2 new cases the strongest correlation was found at a lag of +3 weeks for the term flu. Conclusion: In the last years research in health care has used GT data to explore public interest in various fields of medicine. Caution should be used when interpreting the findings of digital surveillance.


Subject(s)
COVID-19 , Influenza, Human , Humans , Influenza, Human/epidemiology , Internet , Italy/epidemiology , SARS-CoV-2 , Search Engine
12.
Med Sci Monit ; 27: e934862, 2021 12 12.
Article in English | MEDLINE | ID: covidwho-1572935

ABSTRACT

BACKGROUND This population study aimed to investigate influenza and influenza-like respiratory virus infections in children during the 2019/20 influenza season and the coronavirus disease 2019 (COVID-19) pandemic in Poland. MATERIAL AND METHODS This study analyzed data from the National Influenza Centre, the Department of Influenza Research at the National Institute of Public Health, and 16 Voivodeship Sanitary and Epidemiological Stations in Poland. Nose and throat swabs were obtained from children during the 2019/20 influenza season and the COVID-19 pandemic. Viral RNA detection was performed using quantitative reverse transcription-polymerase chain reaction (qRT-PCR) to diagnose influenza virus infection and viral subtypes. RESULTS In the analyzed group, both cases of influenza A and B and infections with influenza-like viruses were confirmed. Among all cases caused by influenza viruses, influenza A was more frequent than B, with predominance of the A/H1N1/pdm09 subtype. The flu-like virus which infected most children was the human respiratory syncytial virus (RSV). The greatest number of cases with RSV was registered in the group of the youngest children (0-4 years). CONCLUSIONS This population study from Poland showed that during the COVID-19 pandemic, and during the winter influenza season of 2019/20, influenza and influenza-like viral infections in children showed some differences from previous influenza seasons. The findings highlight the importance of viral infection surveillance and influenza vaccination in the pediatric population.


Subject(s)
COVID-19 , Influenza, Human/epidemiology , Academies and Institutes , Age Distribution , Child , Child, Preschool , Humans , Infant , Influenza, Human/diagnosis , Male , Pandemics , Poland/epidemiology , Polymerase Chain Reaction , SARS-CoV-2
13.
Zhonghua Yi Xue Za Zhi ; 101(46): 3771-3774, 2021 Dec 14.
Article in Chinese | MEDLINE | ID: covidwho-1572699

ABSTRACT

The lower temperature in autumn-winter provides favorable conditions for the survival and spread of respiratory infectious diseases such as the corona virus disease 2019 (COVID-19) and influenza. It is likely that there will be a co-circulation of respiratory pathogens such as SARS-CoV-2 and influenza. In order to promote the prevention and control of influenza and the application of influenza vaccination during the COVID-19 pandemic in China, we separately discussed the risk of influenza epidemic in the 2021-2022 season, the influenza vaccination policies, and advocate influenza vaccination during the COVID-19 pandemic from the perspective of population medicine. We appeal that COVID-19 vaccination cannot delay the normal delivery of other vaccines in the national immunization programs and non-Expanded Program on Immunization (EPI) vaccines. Promoting influenza vaccination policies and improving immunization service convenience are necessary for increasing influenza vaccine coverage, protecting public health and assisting COVID-19 response.


Subject(s)
COVID-19 , Influenza, Human , COVID-19 Vaccines , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Pandemics , SARS-CoV-2 , Seasons , Vaccination
14.
Popul Stud (Camb) ; 75(sup1): 179-199, 2021 12.
Article in English | MEDLINE | ID: covidwho-1569371

ABSTRACT

Despite common perceptions to the contrary, pandemic diseases do not affect populations indiscriminately. In this paper, we review literature produced by demographers, historians, epidemiologists, and other researchers on disparities during the 1918-20 influenza pandemic and the Covid-19 pandemic. Evidence from these studies demonstrates that lower socio-economic status and minority/stigmatized race or ethnicity are associated with higher morbidity and mortality. However, such research often lacks theoretical frameworks or appropriate data to explain the mechanisms underlying these disparities fully. We suggest using a framework that considers proximal and distal factors contributing to differential exposure, susceptibility, and consequences as one way to move this research forward. Further, current pandemic preparedness plans emphasize medically defined risk groups and epidemiological approaches. Therefore, we conclude by arguing in favour of a transdisciplinary paradigm that recognizes socially defined risk groups, includes input from the social sciences and humanities and other diverse perspectives, and contributes to the reduction of health disparities before a pandemic hits.


Subject(s)
COVID-19 , Influenza, Human , Humans , Influenza, Human/epidemiology , Minority Groups , Pandemics , SARS-CoV-2
15.
MMWR Morb Mortal Wkly Rep ; 70(45): 1575-1578, 2021 Nov 12.
Article in English | MEDLINE | ID: covidwho-1559837

ABSTRACT

Influenza causes considerable morbidity and mortality in the United States. Between 2010 and 2020, an estimated 9-41 million cases resulted in 140,000-710,000 hospitalizations and 12,000-52,000 deaths annually (1). As the United States enters the 2021-22 influenza season, the potential impact of influenza illnesses is of concern given that influenza season will again coincide with the ongoing COVID-19 pandemic, which could further strain overburdened health care systems. The Advisory Committee on Immunization Practices (ACIP) recommends routine annual influenza vaccination for the 2021-22 influenza season for all persons aged ≥6 months who have no contraindications (2). To assess the potential impact of the COVID-19 pandemic on influenza vaccination coverage, the percentage change between administration of at least 1 dose of influenza vaccine during September-December 2020 was compared with the average administered in the corresponding periods in 2018 and 2019. The data analyzed were reported from 11 U.S. jurisdictions with high-performing state immunization information systems.* Overall, influenza vaccine administration was 9.0% higher in 2020 compared with the average in 2018 and 2019, combined. However, in 2020, the number of influenza vaccine doses administered to children aged 6-23 months and children aged 2-4 years, was 13.9% and 11.9% lower, respectively than the average for each age group in 2018 and 2019. Strategic efforts are needed to ensure high influenza vaccination coverage among all age groups, especially children aged 6 months-4 years who are not yet eligible to receive a COVID-19 vaccine. Administration of influenza vaccine and a COVID-19 vaccine among eligible populations is especially important to reduce the potential strain that influenza and COVID-19 cases could place on health care systems already overburdened by COVID-19.


Subject(s)
COVID-19/epidemiology , Influenza Vaccines/administration & dosage , Pandemics , Vaccination/statistics & numerical data , Adolescent , Adult , Advisory Committees , Aged , Centers for Disease Control and Prevention, U.S. , Child , Child, Preschool , Humans , Immunization/standards , Infant , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Middle Aged , Seasons , United States/epidemiology , Young Adult
16.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(10): 1722-1749, 2021 Oct 10.
Article in Chinese | MEDLINE | ID: covidwho-1534280

ABSTRACT

Influenza is a respiratory infectious disease that can seriously affect human health. Influenza virus has frequent antigenic drifts that can facilitate escape from pre-existing population immunity and lead to rapid and widespread transmission. Seasonal influenza is characterized by annual epidemics and outbreaks in places of public gathering such as schools, kindergartens, and nursing homes. According to the World Health Organization (WHO), seasonal influenza causes 3 to 5 million severe cases and 290 000 to 650 000 deaths globally each year. Pregnant women, young children, the elderly, and persons with chronic medical conditions are at highest risk for severe illness and death from influenza virus infection. With the ongoing COVID-19 pandemic, SARS-CoV-2 may co-circulate with influenza and other respiratory viruses in the upcoming winter-spring influenza season. Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from influenza. China has several licensed influenza vaccines - trivalent inactivated influenza vaccines (IIV3), which include split-virus influenza vaccine and subunit vaccine; quadrivalent split-virus inactivated influenza vaccine (IIV4); and trivalent live attenuated influenza vaccine (LAIV3). With the exception of a few major cities, influenza vaccine is a non-program vaccine, which means that influenza vaccination is not included in China's Expanded Program on Immunization, and recipients must pay for influenza vaccine and its administration. China CDC has issued "Technical Guidelines for Seasonal Influenza Vaccination in China" every year from 2018 to 2020. This past year, there have been scientific and programmatic advances in prevention and control of seasonal influenza. To strengthen technical guidance for prevention and control of influenza and facilitate operational research on influenza vaccination, the National Immunization Advisory Committee (NIAC) Influenza Vaccination Technical Working Group (TWG) updated the 2020-2021 technical guidelines into the "Technical Guidelines for Seasonal Influenza Vaccination in China (2021-2022)." The new version has updates in five key areas: (1) new research evidence, especially from studies in China, on disease burden, vaccine effectiveness, vaccine-avoidable disease burden, vaccine safety monitoring, and cost-effectiveness and cost-benefit analyses, (2) policies and measures for influenza prevention and control that were issued by National Health Commission (NHC) in the past year, (3) licensure of a new seasonal influenza vaccine in time for the 2021-2022 season, (4) composition of the northern hemisphere trivalent and quadrivalent influenza vaccines for the 2021-2022 season, and (5) recommendations for influenza vaccination during the 2021-2022 influenza season. The recommendations specify that immunization clinics should provide influenza vaccine to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications; the interval between receipt of influenza vaccine and COVID-19 vaccine should at least 14 days; and there is no preference for one influenza vaccine over another for persons for whom more than one licensed, recommended, and appropriate vaccine is available. Considering the global COVID-19 pandemic and the need to decrease risk of influenza virus infection and minimize potential impact on COVID-19 prevention and control, we recommend the following target population priorities in preparation for the 2021-2022 influenza season: (1) healthcare workers, including clinical doctors and nurses, public health professionals, and quarantine professionals, (2) volunteers and staff who provide service and support for large events, (3) people living in nursing homes or welfare homes and staff who take care of vulnerable, at-risk individuals, (4) people who work in high population density settings, including teachers and students in kindergartens, primary, and secondary schools and prisoners and prison staff, and (5) people with high risk of complications from influenza, including adults ≥60 years of age, children 6-59 months of age, persons with certain chronic conditions, family members and caregivers of infants <6 months of age, and pregnant women and women who plan to become pregnant during the influenza season. Children 6 months through 8 years of age who have never received influenza vaccine or who have received only one lifetime dose require 2 doses of influenza vaccine that are administered at least 4 weeks apart. This recommendation applies to both IIV and LAIV. If children received 2 doses of influenza vaccine in the 2020-2021 influenza season or received more than 2 doses of influenza vaccine in prior influenza seasons, 1 dose of influenza vaccine is recommended. People more than 9 years old require only 1 dose of influenza vaccine. People should receive influenza vaccination by the end of October, and influenza vaccine should be offered as soon as it is available. For people unable to be vaccinated before the end of October, influenza vaccine will continue to be offered throughout the season. Influenza vaccine is recommended for pregnant women during any trimester of pregnancy. These guidelines are intended for use by staff of CDCs at all levels who work on influenza control and prevention; immunization clinic staff members; healthcare workers from departments of pediatrics, internal medicine, and infectious diseases; and staff of maternity and child care institutions at all levels. The guidelines will be periodically updated as new evidence becomes available.


Subject(s)
COVID-19 , Influenza, Human , Aged , COVID-19 Vaccines , Child , Child, Preschool , China/epidemiology , Female , Humans , Infant , Infant, Newborn , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Pandemics , Pregnancy , SARS-CoV-2 , Seasons , Vaccination
17.
JAAPA ; 34(8): 15, 2021 Aug 01.
Article in English | MEDLINE | ID: covidwho-1532550
18.
BMJ Open ; 11(10): e052473, 2021 10 07.
Article in English | MEDLINE | ID: covidwho-1523027

ABSTRACT

PURPOSE: We describe here a multicentric community-dwelling cohort of older adults (>60 years of age) established to estimate incidence, study risk factors, healthcare utilisation and economic burden associated with influenza and respiratory syncytial virus (RSV) in India. PARTICIPANTS: The four sites of this cohort are in northern (Ballabgarh), southern (Chennai), eastern (Kolkata) and western (Pune) parts of India. We enrolled 5336 participants across 4220 households and began surveillance in July 2018 for viral respiratory infections with additional participants enrolled annually. Trained field workers collected data about individual-level and household-level risk factors at enrolment and quarterly assessed frailty and grip strength. Trained nurses surveilled weekly to identify acute respiratory infections (ARI) and clinically assessed individuals to diagnose acute lower respiratory infection (ALRI) as per protocol. Nasal and oropharyngeal swabs are collected from all ALRI cases and one-fifth of the other ARI cases for laboratory testing. Cost data of the episode are collected using the WHO approach for estimating the economic burden of seasonal influenza. Handheld tablets with Open Data Kit platform were used for data collection. FINDINGS TO DATE: The attrition of 352 participants due to migration and deaths was offset by enrolling 680 new entrants in the second year. All four sites reported negligible influenza vaccination uptake (0.1%-0.4%), low health insurance coverage (0.4%-22%) and high tobacco use (19%-52%). Ballabgarh had the highest proportion (54.4%) of households in the richest wealth quintile, but reported high solid fuel use (92%). Frailty levels were highest in Kolkata (11.3%) and lowest in Pune (6.8%). The Chennai cohort had highest self-reported morbidity (90.1%). FUTURE PLANS: The findings of this cohort will be used to inform prioritisation of strategies for influenza and RSV control for older adults in India. We also plan to conduct epidemiological studies of SARS-CoV-2 using this platform.


Subject(s)
COVID-19 , Influenza, Human , Respiratory Syncytial Virus Infections , Respiratory Syncytial Virus, Human , Respiratory Tract Infections , Viruses , Aged , Humans , India/epidemiology , Infant , Influenza, Human/epidemiology , Respiratory Tract Infections/epidemiology , SARS-CoV-2
20.
Euro Surveill ; 26(40)2021 10.
Article in English | MEDLINE | ID: covidwho-1511988

ABSTRACT

BackgroundAnnual seasonal influenza activity in the northern hemisphere causes a high burden of disease during the winter months, peaking in the first weeks of the year.AimWe describe the 2019/20 influenza season and the impact of the COVID-19 pandemic on sentinel surveillance in the World Health Organization (WHO) European Region.MethodsWe analysed weekly epidemiological and virological influenza data from sentinel primary care and hospital sources reported by countries, territories and areas (hereafter countries) in the European Region.ResultsWe observed co-circulation of influenza B/Victoria-lineage, A(H1)pdm09 and A(H3) viruses during the 2019/20 season, with different dominance patterns observed across the Region. A higher proportion of patients with influenza A virus infection than type B were observed. The influenza activity started in week 47/2019, and influenza positivity rate was ≥ 50% for 2 weeks (05-06/2020) rather than 5-8 weeks in the previous five seasons. In many countries a rapid reduction in sentinel reports and the highest influenza activity was observed in weeks 09-13/2020. Reporting was reduced from week 14/2020 across the Region coincident with the onset of widespread circulation of SARS-CoV-2.ConclusionsOverall, influenza type A viruses dominated; however, there were varying patterns across the Region, with dominance of B/Victoria-lineage viruses in a few countries. The COVID-19 pandemic contributed to an earlier end of the influenza season and reduced influenza virus circulation probably owing to restricted healthcare access and public health measures.


Subject(s)
COVID-19 , Influenza, Human , Humans , Influenza, Human/epidemiology , Pandemics , SARS-CoV-2 , Seasons , World Health Organization
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