医护人员中流感样疾病病例定义和急性呼吸道感染病例定义在流感和新冠病毒病诊断中的评估

Evaluation of the influenza-like illness case definition and the acute respiratory infection case definition in the diagnosis of influenza and COVID-19 in healthcare personnel.

作者信息

Maltezou Helena C, Sourri Flora, Lemonakis Nikolaos, Karapanou Amalia, Giannouchos Theodoros V, Gamaletsou Maria N, Koukou Dimitra-Maria, Souliotis Kyriakos, Lourida Athanasia, Panagopoulos Periklis, Hatzigeorgiou Dimitrios, Sipsas Nikolaos V

机构信息

Directorate of Research, Studies and Documentation, National Public Health Organization, Athens, Greece.

251 Hellenic Air Force General Hospital, Athens, Greece.

出版信息

Infect Dis Health. 2025 Feb;30(1):23-27. doi: 10.1016/j.idh.2024.08.002. Epub 2024 Sep 16.

DOI:10.1016/j.idh.2024.08.002

PMID:39289046

Abstract

BACKGROUND

To evaluate the influenza-like illness (ILI) and acute respiratory infection (ARI) case definitions in the diagnosis of COVID-19 and influenza in healthcare personnel (HCP).

METHODS

We followed a cohort of 5752 HCP from November 2022 to May 2023. Symptomatic HCP were tested for SARS-CoV-2 and influenza by real-time PCR and/or rapid antigen detection test. ILI was defined as the sudden onset of ≥1 systemic symptom and ≥1 respiratory symptom. ARI was defined as the sudden onset of ≥1 respiratory symptom. Patients with respiratory symptoms were grouped either as ILI or as ARI based on the presence of fever, malaise, headache and/or myalgia.

RESULTS

Overall, 466 ILI cases and 383 ARI cases occurred. HCP with ILI had an adjusted odds ratio (aOR) of 22.05 [95% confidence interval (CI): 6.23-78.04] to be diagnosed with influenza. HCP with ARI had an aOR of 2.70 (95% CI: 1.88-3.88) to be diagnosed with COVID-19. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ILI for influenza were 96.6%, 49.9%, 18.2%, and 99.2%, respectively. The sensitivity, specificity, PPV, and NPV of ARI for COVID-19 were 51.7%, 73.6%, 84.9%, and 34.8%, respectively. ILI and ARI had an overall correct classification rate of 89.6% and 74.1%, respectively.

CONCLUSION

Our findings support the use of both ILI and ARI case definitions in the diagnosis of influenza and COVID-19 in HCP.

摘要

背景

评估医护人员（HCP）中流感样疾病（ILI）和急性呼吸道感染（ARI）病例定义在新冠病毒病（COVID-19）和流感诊断中的作用。

方法

我们对2022年11月至2023年5月的5752名医护人员进行了队列研究。有症状的医护人员通过实时聚合酶链反应（PCR）和/或快速抗原检测试验检测SARS-CoV-2和流感病毒。ILI定义为突然出现≥1种全身症状和≥1种呼吸道症状。ARI定义为突然出现≥1种呼吸道症状。有呼吸道症状的患者根据是否存在发热、乏力、头痛和/或肌痛分为ILI或ARI。

结果

总体而言，发生了466例ILI病例和383例ARI病例。患有ILI的医护人员被诊断为流感的调整优势比（aOR）为22.05[95%置信区间（CI）：6.23-78.04]。患有ARI的医护人员被诊断为COVID-19的aOR为2.70（95%CI：1.88-3.88）。ILI对流感的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为96.6%、49.9%、18.2%和99.2%。ARI对COVID-19的敏感性、特异性、PPV和NPV分别为51.7%、73.6%、84.9%和34.8%。ILI和ARI的总体正确分类率分别为89.6%和74.1%。