Linking digital surveillance and in-depth virology to study clinical patterns of viral respiratory infections in vulnerable patient populations

Obermeier, Patrick; Heim, Albert; Biere, Barbara; Hage, Elias; Alchikh, Maren; Conrad, Tim; Schweiger, Brunhilde; Rath, Barbara

doi:10.1016/j.isci.2022.104276

Cited by 4 publications

(5 citation statements)

References 65 publications

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“…The score consists of nine items DSU: disease severity, uncomplicated, weighed single-fold and 13 items DSC: disease severity, complicated, weighed threefold. ViVI Score values may range from 0–48 [ 21 ].…”

Section: Resultsmentioning

confidence: 99%

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Successful Treatment of Complicated Influenza A(H3N2) Virus Infection and Rhabdomyolysis with Compassionate Use of IV Zanamivir

et al. 2023

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In 2019, EMA licensed intravenous (IV) zanamivir for severe influenza virus infection in children over 6 months as well as adults. Prior to that, it was possible via a compassionate use program. We present successful compassionate use of IV zanamivir in a 14-year-old female with severe influenza A(H3N2) and multi-organ failure, who had failed oral oseltamivir. Her illness was complicated by acute respiratory distress syndrome and rhabdomyolysis requiring extracorporeal membrane oxygenation and hemofiltration. Considering the broad safety margins with neuraminidase inhibitors, an adult dose of 600 mg IV BID was administered in this 60 kg patient. Influenza virus was cleared rapidly and undetectable on day 13. Creatine kinase (CK) values were dropping from 38,000 to 500 within nine days. Given the recent licensure of IV zanamivir, multi-center prospective observational studies in pediatric Intensive Care Unit patients would be beneficial to guide the most appropriate use of IV zanamivir in this vulnerable age group.

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Section: Resultsmentioning

confidence: 99%

“…The peak (ViVI Disease Severity Score of 31, >99 percentile) was reached on day three of illness, when the patient was diagnosed with shock [ 21 ]. Under 7 days of oral oseltamivir therapy, ViVI-Scores had decreased slightly, from 31 to 27.…”

Section: Resultsmentioning

confidence: 99%

Successful Treatment of Complicated Influenza A(H3N2) Virus Infection and Rhabdomyolysis with Compassionate Use of IV Zanamivir

et al. 2023

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“…The VIVI Score as well as the mobile app were subsequently validated in single- and multi-center studies in Europe (PEDSIDEA) and the USA [ 10 ]. VIVI Scores can range from 0 to 48 [ 8 , 10 , 11 , 12 ].…”

Section: Methodsmentioning

confidence: 99%

“…The present study was conducted in the context of a six-year quality improvement (QI) program, where all patients aged 0–18 years who fulfilled a predefined ILI case definition (fever ≥ 38 °C and ≥1 respiratory symptom or physician-documented ILI) received laboratory RT-PCR diagnostics [ 7 ]. To determine disease severity and risk factors consistently across all patients participating in the QI program, we used a previously published and validated composite clinical score, the VIVI Disease Severity Score, capturing 22 key variables in real time via a mobile app (the VIVI ScoreApp, Vaccine Safety Initiative, Berlin, Germany) [ 7 , 8 , 9 , 10 , 11 , 12 ]. Disease severity and individual risk factors were therefore systematically captured in all patients in compliance with clinical data standards.…”

Section: Introductionmentioning

confidence: 99%

Disease Burden and Inpatient Management of Children with Acute Respiratory Viral Infections during the Pre-COVID Era in Germany: A Cost-of-Illness Study

Alchikh,

Conrad,

Obermeier

et al. 2024

Viruses

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Respiratory viral infections (RVIs) are common reasons for healthcare consultations. The inpatient management of RVIs consumes significant resources. From 2009 to 2014, we assessed the costs of RVI management in 4776 hospitalized children aged 0–18 years participating in a quality improvement program, where all ILI patients underwent virologic testing at the National Reference Centre followed by detailed recording of their clinical course. The direct (medical or non-medical) and indirect costs of inpatient management outside the ICU (‘non-ICU’) versus management requiring ICU care (‘ICU’) added up to EUR 2767.14 (non-ICU) vs. EUR 29,941.71 (ICU) for influenza, EUR 2713.14 (non-ICU) vs. EUR 16,951.06 (ICU) for RSV infections, and EUR 2767.33 (non-ICU) vs. EUR 14,394.02 (ICU) for human rhinovirus (hRV) infections, respectively. Non-ICU inpatient costs were similar for all eight RVIs studied: influenza, RSV, hRV, adenovirus (hAdV), metapneumovirus (hMPV), parainfluenza virus (hPIV), bocavirus (hBoV), and seasonal coronavirus (hCoV) infections. ICU costs for influenza, however, exceeded all other RVIs. At the time of the study, influenza was the only RVI with antiviral treatment options available for children, but only 9.8% of influenza patients (non-ICU) and 1.5% of ICU patients with influenza received antivirals; only 2.9% were vaccinated. Future studies should investigate the economic impact of treatment and prevention of influenza, COVID-19, and RSV post vaccine introduction.

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“…The present study was conducted in the context of a six-year Quality Improvement (QI) program, where all patients aged 0-18 years who fulfilled a predefined ILI case definition (fever 38°C and  1 respiratory symptom or physician-documented ILI) received laboratory RT-PCR diagnostics [7]. To determine disease severity and risk factors consistently across all patients participating in the QI program, we used a previously published and validated composite clinical score, the VIVI Disease Severity Score, capturing key 22 variables in real-time via mobile app (the VIVI ScoreApp) [7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Disease Burden and Inpatient Management of Children with Acute Respiratory Viral Infections during the Pre-COVID Era in Germany: A Cost-of-Illness Study

Alchikh,

Conrad,

Obermeier

et al. 2023

Preprint

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Respiratory viral infections (RVI) are common reasons for healthcare consultations. The inpatient management of RVI consumes significant resources. From 2009-2014, we assessed the costs of RVI management in 4776 hospitalized chil-dren aged 0-18 years participating in a quality improvement program, where all ILI patients underwent virologic testing at the National Reference Centre followed by de-tailed recording of their clinical course. The direct (medical or non-medical) and indirect costs of inpatient management outside the ICU (“non-ICU”) versus management requiring ICU-care (“ICU”) added up to 2,767.14€ (non-ICU) vs. 29,941.71€ (ICU) for Influenza, 2,713.14€ (non-ICU) vs. 16,951.06€ (ICU) for RSV infections, and 2,767.33€ (non-ICU) vs. 14,394.02€ (ICU) for human rhinovirus (hRV) infections, respectively. Non-ICU inpatient costs were similar for all 8 RVI studied: Influenza, RSV, hRV, ade-novirus (hAdV), metapneumovirus (hMPV), parainfluenzavirus (hPIV), bocavirus (hBoV) and seasonal coronavirus (hCoV) infections. ICU-costs for Influenza however, ex-ceeded all other RVI. At the time of the study, Influenza was the only RVI with antivi-ral treatment options available for children, but only 9.8% of Influenza patients (non-ICU) and 1.5% of ICU-patients with Influenza received antivirals; only 2.9% were vac-cinated. Future studies should investigate the economic impact of treatment and pre-vention of Influenza-, COVID-19-, and RSV post vaccine introduction.

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Linking digital surveillance and in-depth virology to study clinical patterns of viral respiratory infections in vulnerable patient populations

Cited by 4 publications

References 65 publications

Successful Treatment of Complicated Influenza A(H3N2) Virus Infection and Rhabdomyolysis with Compassionate Use of IV Zanamivir

Successful Treatment of Complicated Influenza A(H3N2) Virus Infection and Rhabdomyolysis with Compassionate Use of IV Zanamivir

Disease Burden and Inpatient Management of Children with Acute Respiratory Viral Infections during the Pre-COVID Era in Germany: A Cost-of-Illness Study

Disease Burden and Inpatient Management of Children with Acute Respiratory Viral Infections during the Pre-COVID Era in Germany: A Cost-of-Illness Study

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