Torres Ana Rita, Gómez Verónica, Kislaya Irina, Rodrigues Ana Paula, Fernandes Tavares Margarida, Pereira Ana Catarina, Pereira Débora, Côrte-Real Rita, Flores Carlos Humberto, Verdasca Nuno, Guiomar Raquel, Machado Ausenda
Department of Epidemiology, National Health Institute Doutor Ricardo Jorge, Portugal.
Public Health Research Center, NOVA National School of Public Health, Lisbon, Portugal.
Can J Infect Dis Med Microbiol. 2023 Feb 16;2023:6590011. doi: 10.1155/2023/6590011. eCollection 2023.
Severe acute respiratory infections (SARI) surveillance is recommended to assess the severity of respiratory infections disease. In 2021, the National Institute of Health Doutor Ricardo Jorge, in collaboration with two general hospitals, implemented a SARI sentinel surveillance system based on electronic health registries. We describe its application in the 2021/2022 season and compare the evolution of SARI cases with the COVID-19 and influenza activity in two regions of Portugal.
The main outcome of interest was the weekly incidence of patients hospitalized due to SARI, reported within the surveillance system. SARI cases were defined as patients containing ICD-10 codes for influenza-like illness, cardiovascular diagnosis, respiratory diagnosis, and respiratory infection in their primary admission diagnosis. Independent variables included weekly COVID-19 and influenza incidence in the North and Lisbon and Tagus Valley regions. Pearson and cross-correlations between SARI cases, COVID-19 incidence and influenza incidence were estimated.
A high correlation between SARI cases or hospitalizations due to respiratory infection and COVID-19 incidence was obtained ( = 0.78 and = 0.82, respectively). SARI cases detected the COVID-19 epidemic peak a week earlier. A weak correlation was observed between SARI and influenza cases ( = -0.20). However, if restricted to hospitalizations due to cardiovascular diagnosis, a moderate correlation was observed ( = 0.37). Moreover, hospitalizations due to cardiovascular diagnosis detected the increase of influenza epidemic activity a week earlier.
In the 2021/2022 season, the Portuguese SARI sentinel surveillance system pilot was able to early detect the COVID-19 epidemic peak and the increase of influenza activity. Although cardiovascular manifestations associated with influenza infection are known, more seasons of surveillance are needed, to confirm the potential use of cardiovascular hospitalizations as an indicator of influenza activity.
建议开展严重急性呼吸道感染（SARI）监测以评估呼吸道感染疾病的严重程度。2021年，国家卫生研究院里卡多·豪尔赫博士与两家综合医院合作，基于电子健康记录实施了SARI哨点监测系统。我们描述了该系统在2021/2022季节的应用情况，并比较了葡萄牙两个地区SARI病例的演变情况与新冠病毒病和流感活动情况。
主要关注的结果是监测系统报告的因SARI住院患者的周发病率。SARI病例定义为初次入院诊断中包含国际疾病分类第十版（ICD - 10）中流感样疾病、心血管诊断、呼吸道诊断和呼吸道感染代码的患者。自变量包括北部、里斯本和塔霍河谷地区的每周新冠病毒病和流感发病率。估计了SARI病例、新冠病毒病发病率和流感发病率之间的皮尔逊相关性和交叉相关性。
因呼吸道感染导致的SARI病例或住院人数与新冠病毒病发病率之间存在高度相关性（分别为r = 0.78和r = 0.82）。SARI病例比新冠病毒病疫情高峰提前一周检测到。SARI与流感病例之间观察到弱相关性（r = -0.20）。然而，如果仅限于因心血管诊断住院的情况，则观察到中度相关性（r = 0.37）。此外，因心血管诊断住院的情况比流感流行活动增加提前一周检测到。
在2021/2022季节，葡萄牙SARI哨点监测系统试点能够早期检测到新冠病毒病疫情高峰和流感活动增加。尽管已知流感感染会出现心血管表现，但需要更多季节的监测来确认将心血管住院作为流感活动指标的潜在用途。
