State‐level estimates of excess hospitalizations and deaths associated with influenza

Czaja, Christopher A.; Miller, Lisa; Colborn, Kathryn; Cockburn, Myles; Alden, Nisha; Herlihy, Rachel; Simões, Eric A F

doi:10.1111/irv.12700

Cited by 14 publications

(25 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In line with previous studies 6, [48][49][50] , influenza-associated mortality rate was found the highest among adults aged ≥ 65 years. Our pooled influenza-associated respiratory mortality rate (5.84 per 100,000 persons) fell within the estimate for the Western Pacific region reported in a global study (3.6-7.5 per 100,000 persons) 2 .…”

Section: Discussionsupporting

confidence: 92%

“…Our pooled estimates were also comparable with the corresponding estimates published for other countries or regions; e.g. our pooled excess all-cause mortality rate (14.33 per 100,000 persons) was similar to those reported in Europe (13.30 per 100,000 persons) 48 and Hong Kong SAR (11.70 per 100,000 persons) 6 , but slightly higher than that reported in the USA (6.96 per 100,000 persons) 49 and South Korea (5.97 per 100,000 persons) 50 . Our influenza-associated P&I (384 per 100,000 persons) or SARI (442–715 per 100,000 persons) hospitalization rate among children aged < 5 years was much higher than those reported for Singapore (excess P&I hospitalization rate of 186.8 per 100,000 persons) 51 , Portugal (excess P&I hospitalization rate of 42.6 per 100,000 persons) 52 , Chile (excess SARI hospitalization rate of 71.5 per 100, 000 persons) 53 .…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Influenza-associated disease burden in mainland China: a systematic review and meta-analysis

Chen

Wang

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Influenza causes substantial morbidity and mortality. Many original studies have been carried out to estimate disease burden of influenza in mainland China, while the full disease burden has not yet been systematically reviewed. We did a systematic review and meta-analysis to assess the burden of influenza-associated mortality, hospitalization, and outpatient visit in mainland China. We searched 3 English and 4 Chinese databases with studies published from 2005 to 2019. Studies reporting population-based rates of mortality, hospitalization, or outpatient visit attributed to seasonal influenza were included in the analysis. Fixed-effects or random-effects model was used to calculate pooled estimates of influenza-associated mortality depending on the degree of heterogeneity. Meta-regression was applied to explore the sources of heterogeneity. Publication bias was assessed by funnel plots and Egger’s test. We identified 30 studies eligible for inclusion with 17, 8, 5 studies reporting mortality, hospitalization, and outpatient visit associated with influenza, respectively. The pooled influenza-associated all-cause mortality rates were 14.33 and 122.79 per 100,000 persons for all ages and ≥ 65 years age groups, respectively. Studies were highly heterogeneous in aspects of age group, cause of death, statistical model, geographic location, and study period, and these factors could explain 60.14% of the heterogeneity in influenza-associated mortality. No significant publication bias existed in estimates of influenza-associated all-cause mortality. Children aged < 5 years were observed with the highest rates of influenza-associated hospitalizations and ILI outpatient visits. People aged ≥ 65 years and < 5 years contribute mostly to mortality and morbidity burden due to influenza, which calls for targeted vaccination policy for older adults and younger children in mainland China.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Influenza-associated disease burden in mainland China: a systematic review and meta-analysis

Chen

Wang

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…To estimate the burden of death due to novel respiratory pathogens, previous studies have compared the observed incidence of influenza-related deaths ascribed to pneumonia and influenza (“P&I”) with the baseline incidence of P&I that would be expected at that time of year. 5, 6 These “excess deaths” provide an estimate of pathogen-specific burden. This approach was used in the early months of the 2009 influenza A/H1N1-pdm pandemic; it was estimated that just 1 in 7 pandemic-related deaths was captured by laboratory testing in 2009 in the US.…”

Section: Introductionmentioning

confidence: 99%

Estimating the early death toll of COVID-19 in the United States

Weinberger¹,

Cohen²,

Crawford

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Efforts to track the severity and public health impact of the novel coronavirus, COVID-19, in the US have been hampered by testing issues, reporting lags, and inconsistency between states. Evaluating unexplained increases in deaths attributed to broad outcomes, such as pneumonia and influenza (P&I) or all causes, can provide a more complete and consistent picture of the burden caused by COVID-19. Methods We evaluated increases in the occurrence of deaths due to P&I above a seasonal baseline (adjusted for influenza activity) or due to any cause across the United States in February and March 2020. These estimates are compared with reported deaths due to COVID-19 and with testing data. Results There were notable increases in the rate of death due to P&I in February and March 2020. In a number of states, these deaths pre-dated increases in COVID-19 testing rates and were not counted in official records as related to COVID-19. There was substantial variability between states in the discrepancy between reported rates of death due to COVID-19 and the estimated burden of excess deaths due to P&I. The increase in all-cause deaths in New York and New Jersey is 1.5-3 times higher than the official tally of COVID-19 confirmed deaths or the estimated excess death due to P&I. Conclusions Excess P&I deaths provide a conservative estimate of COVID-19 burden and indicate that COVID-19-related deaths are missed in locations with inadequate testing or intense pandemic activity.

show abstract

“…We obtained estimates for seasonal influenza-and RSV-attributable cardiorespiratory hospitalizations by fitting negative binomial regression excess models, a method commonly used in surveillance studies. 8,31,32 Candidate models that were fit and compared consisted of different linear combinations of ( 1 E(Y i ) = α × exp β lag(H1N1pdm09) i + β 7 lag(H3N2) i + β 8 lag(B) i + β 9 lag(RSVpcr) i ( )…”

Section: Discussionmentioning

confidence: 99%

“…In particular, influenza and RSV infections commonly have cardiorespiratory sequelae that include acute myocardial infarction, stroke, and exacerbation of asthma and chronic obstructive pulmonary disease. [4][5][6] Although evidence of the incidence and risk factors for influenza and RSV infections among older adults is starting to emerge, 4,[7][8][9][10][11][12][13][14] little is known about the implications of these respiratory viruses for the most vulnerable group: residents of long-term care facilities (LTCFs).…”

Section: Introductionmentioning

confidence: 99%

Estimated Cardiorespiratory Hospitalizations Attributable to Influenza and Respiratory Syncytial Virus Among Long-term Care Facility Residents

et al. 2021

View full text Add to dashboard Cite

IMPORTANCE Older adults residing in long-term care facilities (LTCFs) are at a high risk of being infected with respiratory viruses, such as influenza and respiratory syncytial virus (RSV). Although these infections commonly have many cardiorespiratory sequelae, the national burden of influenzaand RSV-attributable cardiorespiratory events remains unknown for the multimorbid and vulnerable LTCF population.OBJECTIVE To estimate the incidence of cardiorespiratory hospitalizations that were attributable to influenza and RSV among LTCF residents and to quantify the economic burden of these hospitalizations on the US health care system by estimating their associated cost and length of stay. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used national MedicareProvider Analysis and Review inpatient claims and Minimum Data Set clinical assessments for 6 respiratory seasons (2011)(2012)(2013)(2014)(2015)(2016)(2017). Long-stay residents of LTCFs were identified as those living in the facility for at least 100 days (index date), aged 65 years or older, and with 6 months of continuous enrollment in Medicare Part A were included. Follow-up occurred from the resident's index date until the first hospitalization, discharge from the LTCF, disenrollment from Medicare, death, or the end of the study. Residents could re-enter the sample; thus, long-stay episodes of care were identified. Data analysis was performed between January 1 and September 30, 2020.EXPOSURES Seasonal circulating pandemic 2009 influenza A(H1N1), human influenza A(H3N2), influenza B, and RSV. MAIN OUTCOMES AND MEASURESCardiorespiratory hospitalizations (eg, asthma exacerbation, heart failure) were identified using primary diagnosis codes. Influenza-and RSV-attributable cardiorespiratory events were estimated using a negative binomial regression model adjusted for weekly circulating influenza and RSV testing data. Length of stay and costs of influenza-and RSV-attributable events were then estimated. RESULTSThe study population comprised 2 909 106 LTCF residents with 3 138 962 long-stay episodes and 5 079 872 person-years of follow-up. Overall, 10 939 (95% CI, 9413-12 464) influenzaand RSV-attributable cardiorespiratory events occurred, with an incidence of 215 (95% CI, 185-245) events per 100 000 person-years. The cost of influenza-and RSV-attributable cardiorespiratory events was $91 055 393 (95% CI, $77 885 316-$104 225 470), and the length of stay was 56 858 (95% CI, 48 757-64 968) days. CONCLUSIONS AND RELEVANCEThis study found that many cardiorespiratory hospitalizations among LTCF residents in the US were attributable to seasonal influenza and RSV. To minimize the (continued) Key Points Question What is the burden of cardiorespiratory events attributable to influenza and respiratory syncytial virus (RSV) among older adults residing in long-term care facilities (LTCFs) in the US? Findings In this cohort study of 2 909 106 LTCF residents, a total of 10 939 influenza-and RSV-attributable cardiorespiratory events occurred from 2011 to 2017 f...

show abstract

State‐level estimates of excess hospitalizations and deaths associated with influenza

Cited by 14 publications

References 25 publications

Influenza-associated disease burden in mainland China: a systematic review and meta-analysis

Influenza-associated disease burden in mainland China: a systematic review and meta-analysis

Estimating the early death toll of COVID-19 in the United States

Estimated Cardiorespiratory Hospitalizations Attributable to Influenza and Respiratory Syncytial Virus Among Long-term Care Facility Residents

Contact Info

Product

Resources

About