Egeskov-Cavling Amanda Marie, Hansen Chelsea L, Johannesen Caroline Klint, Lindegaard Birgitte, Bhatt Samir, Viboud Cecile, Fischer Thea K
Department of Clinical Research, North Zealand Hospital, Hilleroed, Denmark.
Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
Lancet Reg Health Eur. 2025 Jul 18;55:101396. doi: 10.1016/j.lanepe.2025.101396. eCollection 2025 Aug.
Understanding the long-term epidemiology trends of RSV, influenza, and COVID-19 is essential for planning of vaccination strategies and healthcare system epidemic preparedness. This is the first study to provide a comprehensive estimation of both excess mortality and hospitalisations among adults for these respiratory viruses in a European setting. We aim to estimate excess mortality and excess hospitalisations for RSV, influenza, and COVID-19 among adults ≥18 years in Denmark from January 2015 to March 2024.
This nationwide time-trend modelling study investigates weekly mortality and hospitalisation rates surpassing the seasonal baseline for RSV, influenza, and COVID-19 among adults in Denmark. Data from the Cause of Death Register, the Danish National Patient Registry, and respiratory virus surveillance data were analysed with Generalized Additive Models (GAM) using a negative binomial likelihood function, including RSV, influenza, COVID-19 variants, and time effects to account for seasonality and trend.
We estimated 3944 RSV-attributed, 5675 influenza-attributed, and 5636 COVID-19-attributed deaths. Among adults aged 65 or older, the annual mortality rates were 31.2 per 100,000 for RSV, 42.9 for influenza, and 88.5 for COVID-19. Furthermore, we estimated annual admission rates for those aged 65 and older of 177.4 per 100,000 for RSV, 164.6 for influenza, and 398.7 for COVID-19.
This modelling study reveals a substantial impact of RSV on individuals aged 65 and older, with a notable increase in RSV-attributed deaths and hospitalisations in recent years likely due to expanded respiratory testing after the COVID-19 pandemic. Our findings highlight the need for increased awareness in previously considered lower-risk patients, and establish benchmarks for evaluating preventive interventions.
This study received funding from Independent Research Fund Denmark.
了解呼吸道合胞病毒（RSV）、流感和新冠病毒（COVID-19）的长期流行病学趋势对于规划疫苗接种策略和医疗系统的疫情防范至关重要。这是第一项在欧洲背景下全面估计这些呼吸道病毒导致的成人超额死亡率和住院率的研究。我们旨在估计2015年1月至2024年3月丹麦18岁及以上成年人中RSV、流感和COVID-19的超额死亡率和超额住院率。
这项全国性的时间趋势建模研究调查了丹麦成年人中RSV、流感和COVID-19超过季节性基线的每周死亡率和住院率。使用负二项式似然函数的广义相加模型（GAM）分析了来自死亡原因登记册、丹麦国家患者登记册的数据以及呼吸道病毒监测数据，包括RSV、流感、COVID-19变体以及考虑季节性和趋势的时间效应。
我们估计有3944例归因于RSV的死亡、5675例归因于流感的死亡和5636例归因于COVID-19的死亡。在65岁及以上的成年人中，RSV的年死亡率为每10万人31.2例，流感为42.9例，COVID-19为88.5例。此外，我们估计65岁及以上人群中RSV的年住院率为每10万人177.4例，流感为164.6例，COVID-19为398.7例。
这项建模研究揭示了RSV对65岁及以上人群有重大影响，近年来RSV归因的死亡和住院人数显著增加，这可能是由于COVID-19大流行后呼吸道检测范围扩大所致。我们的研究结果强调了需要提高对先前认为风险较低患者的认识，并为评估预防干预措施建立基准。
本研究获得了丹麦独立研究基金的资助。
