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Excess hospitalizations and mortality associated with seasonal influenza in Portugal, 2008–2018

2022-12Artigo científico Acesso aberto
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dc.contributor.authorFroes, Filipe
dc.contributor.authorCarmo, Mafalda
dc.contributor.authorLopes, Hugo
dc.contributor.authorBizouard, Geoffray
dc.contributor.authorGomes, Catarina
dc.contributor.authorMartins, Margarida
dc.contributor.authorBricout, Hélène
dc.contributor.authorde Courville, Caroline
dc.contributor.authorde Sousa, Jaime Correia
dc.contributor.authorRabaçal, Carlos
dc.contributor.authorRaposo, João F.
dc.contributor.authorCordeiro, Carlos Robalo
dc.contributor.institutionCentro de Investigação em Saúde Pública (CISP/PHRC)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - Pólo ENSP
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblSpringer Verlag
dc.date.accessioned2023-03-30T22:20:28Z
dc.date.available2023-03-30T22:20:28Z
dc.date.issued2022-12
dc.descriptionFunding Information: The BARI study was funded by Sanofi. Funding Information: CG, MM, HB, and CDC are Sanofi employees. MC, HL, and GB are IQVIA employees. FF, JCDS, CR, JFR, and CRC have received fees from Sanofi. JCDS reports Advisory Board from Boehringer Ingelheim; personal fees and Advisory Board from GSK; grants, personal fees, and Advisory Board from AstraZeneca; personal fees and Advisory Board from Bial; non-financial support from Mundipharma; personal fees from Sanofi; Advisory Board from Novartis, outside the submitted work. FF reports Advisory Board and personal fees from Sanofi, Pfizer, MSD, Gilead and personal fees or non-financial support from Bial, AstraZeneca, GSK, Novartis, Boehringer Ingelheim, Tecnifar, Lilly, Bayer, and Roche outside the submitted work. Publisher Copyright: © 2022, The Author(s).
dc.description.abstractBackground: Influenza can have a domino effect, triggering severe conditions and leading to hospitalization or even death. Since influenza testing is not routinely performed, statistical modeling techniques are increasingly being used to estimate annual hospitalizations and deaths associated with influenza, to overcome the known underestimation from registers coded with influenza-specific diagnosis. The aim of this study was to estimate the clinical and economic burden of severe influenza in Portugal. Methods: The study comprised ten epidemic seasons (2008/09–2017/18) and used two approaches: (i) a direct method of estimating the seasonal influenza hospitalization incidence, based on the number of National Health Service hospitalizations with influenza-specific International Classification of Diseases (ICD) codes (ICD-9: 487–488; ICD-10: J09-J11), as primary or secondary diagnosis; (ii) an indirect method of estimating excess hospitalizations and deaths using broader groups of ICD codes in time-series models, computed for six age groups and four groups of diagnoses: pneumonia or influenza (ICD-9: 480–488, 517.1; ICD-10: J09–J18), respiratory (ICD-9: 460–519; ICD-10: J00–J99), respiratory or cardiovascular (R&C, ICD-9: 390–459, 460–519; ICD-10: I00–I99, J00–J99), and all-cause. Means are reported excluding the H1N1pdm09 pandemic (2009/10). Results: The mean number of hospitalizations coded as due to influenza per season was 1,207, resulting in 11.6 cases per 100,000 people. The mean direct annual cost of these hospitalizations was €3.9 million, of which 78.6% was generated by patients with comorbidities. Mean annual influenza-associated R&C hospitalizations were estimated at 5356 (min: 456; max: 8776), corresponding to 51.5 cases per 100,000 (95% CI: 40.9–62.0) for all age groups and 199.6 (95% CI: 163.9–235.8) for the population aged ≥ 65 years. The mean direct annual cost of the estimated excess R&C hospitalizations was €15.2 million for all age groups and €12.8 million for the population aged ≥ 65 years. Mean annual influenza-associated all-cause deaths per 100,000 people were estimated at 22.7 for all age groups. Conclusions: The study findings suggest that there is an under-detection of influenza in the Portuguese population. A high burden of severe influenza remains to be addressed, not only in the elderly population but also in younger people.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1467143
dc.identifier.doi10.1186/s12879-022-07713-8
dc.identifier.issn2374-4235
dc.identifier.otherPURE: 57307483
dc.identifier.otherPURE UUID: 3a048eec-22b2-4666-90a1-743021538f10
dc.identifier.otherScopus: 85137534503
dc.identifier.otherPubMed: 36071375
dc.identifier.otherWOS: 000850794700002
dc.identifier.otherPubMedCentral: PMC9450401
dc.identifier.urihttp://hdl.handle.net/10362/151441
dc.identifier.urlhttps://www.scopus.com/pages/publications/85137534503
dc.language.isoeng
dc.peerreviewedyes
dc.subjectBurden
dc.subjectCardiovascular
dc.subjectExcess
dc.subjectHospitalization
dc.subjectInfluenza
dc.subjectMortality
dc.subjectPortugal
dc.subjectRespiratory
dc.subjectInfectious Diseases
dc.subjectSDG 3 - Good Health and Well-being
dc.titleExcess hospitalizations and mortality associated with seasonal influenza in Portugal, 2008–2018en
dc.typejournal article
degois.publication.issue1
degois.publication.titleBMC Infectious Diseases
degois.publication.volume22
dspace.entity.typePublication
rcaap.rightsopenAccess

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