Establishing severe acute respiratory infection (SARI) surveillance in a sentinel hospital, Ireland, 2021 to 2022

ObjectivesWe report the findings of a novel enhanced syndromic surveillance which characterised influenza- and SARS-CoV-2-associated severe acute respiratory illness (SARI) in the 2021/2022 winter season.MethodsProspective cohort study of adults admitted to the Queen Elizabeth University Hospital, Glasgow, with a severe acute respiratory illness. Patient demographics, clinical history, admission details, and outcome were recorded.ResultsBetween November 2021 and May 2022, 1,063 hospitalised SARI episodes in 1,037 adult patients were identified. Median age was 72.0 years and 44.5% were male. Most (82.6%) SARI cases had ≥1 co-morbidity; chronic lung disease (50.0%) and malignancy (22.5%) were the most frequently reported.Overall, 229 (22%) and 33 (3%) SARI episodes were SARS-CoV-2 and influenza A PCR positive, respectively. Overall, 74.7%, 6.5% and 43.0% SARI episodes received antibiotics, antivirals, and steroids, respectively (54.5, 11.0 and 51.3% among COVID-19 patients). 1.1% required mechanical ventilation and 7.8% died. Male sex, multimorbidity, frailty, respiratory rate >30, low GCS and chest X-ray consolidation were predictive of in-hospital mortality.ConclusionOur syndromic surveillance provided near real-time data on hospitalised SARI to clinicians and Public Health Scotland, and informed them of the evolving clinical epidemiology of SARS-CoV-2 and influenza as we transition from the pandemic phase.

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Epidemiology and burden of Severe Acute Respiratory Infections (SARI) in the aftermath of COVID-19 pandemic: A prospective sentinel surveillance study in a Tunisian Medical ICU, 2022/2023

Boussarsar,

Ennouri,

Habbachi

et al. 2023

PLoS ONE

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Background Severe Acute Respiratory Infections (SARI) caused by influenza and other respiratory viruses pose significant global health challenges, and the COVID-19 pandemic has further strained healthcare systems. As the focus shifts from the pandemic to other respiratory infections, assessing the epidemiology and burden of SARI is crucial for healthcare planning and resource allocation. Aim: to understand the impact of the post-pandemic period on the epidemiology of SARI cases, clinical outcomes, and healthcare resource utilization in Tunisia. Methods This is a prospective study conducted in a Tunisian MICU part of a national sentinel surveillance system, focusing on enhanced SARI surveillance. SARI cases from week 39/2022, 26 September to week 19/2023, 13 May were included, according to a standardized case definition. Samples were collected for virological RT-PCR testing, and an electronic system ensured standardized and accurate data collection. Descriptive statistics were performed to assess epidemiology, trends, and outcomes of SARI cases, and univariate/multivariate analyses to assess factors associated with mortality. Results Among 312 MICU patients, 164 SARI cases were identified during the study period. 64(39%) RT-PCR were returned positive for at least one pathogen, with influenza A and B strains accounting for 20.7% of cases at the early stages of the influenza season. The MICU experienced a significant peak in admissions during weeks 1-11/2023, leading to resource mobilization and the creation of a surge unit. SARI cases utilized 1664/3120 of the MICU-stay days and required 1157 mechanical ventilation days. The overall mortality rate among SARI cases was 22.6%. Age, non-COPD, and ARDS were identified as independent predictors of mortality. Conclusions The present study identified a relatively high rate of SARI cases, with 39% positivity for at least one respiratory virus, with influenza A and B strains occurring predominantly during the early stages of the influenza season. The findings shed light on the considerable resource utilization and mortality associated with these infections, underscoring the urgency for proactive management and efficient resource allocation strategies.

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Establishing severe acute respiratory infection (SARI) surveillance in a sentinel hospital, Ireland, 2021 to 2022

Cited by 3 publications

References 12 publications

Implementation and evaluation of a SARI surveillance system in a tertiary hospital in Scotland in 2021/2022

Implementation and evaluation of a SARI surveillance system in a tertiary hospital in Scotland in 2021/2022

Adults with Severe Acute Respiratory Illness in Glasgow, 2021-22: A Prospective Cohort Study

Epidemiology and burden of Severe Acute Respiratory Infections (SARI) in the aftermath of COVID-19 pandemic: A prospective sentinel surveillance study in a Tunisian Medical ICU, 2022/2023

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