Many patients receive antitussives after ACEI initiation. This suggests that ACEI-induced cough is often either not recognized as being ACEI related or is symptomatically treated. Such prescription behaviour may decrease ACEI therapy compliance.

Highlights The cost-effectiveness (CE) of influenza vaccination varied between countries. This was caused by differences in influenza epidemiology, HIV prevalence and unit costs. CE of QIV depends on the countries' influenza B burden, CE thresholds and budgetary impact QIV would only be cost-effective when high influenza attack rates were assumed. Vaccine price of QIV has a high impact on the CE.

Physical exercise can improve sputum clearance in patients with cystic fibrosis (CF). To set up individual training protocols it is desirable to know the anaerobic threshold (AT). Established methods such as blood lactate measurements and ergometry can only be performed in specialized centers. Conconi showed that the heart rate threshold (HRT), i.e., the deflection point from the linear relationship between work load and heart rate, correlated significantly with the AT in healthy adults. To assess the reliability of the HRT in CF, we performed ergometry in 32 CF patients (mean age, 21.0 ± 5.5 years; mean Shwachman score, 77.8 ± 12.0) according to the Conconi protocol. The HRT was compared with the aerobic threshold (AeT) as determined by the V‐slope method and with two turn points in the lactate performance curve (LTP1, LTP2). An HRT could be obtained in only 17 of the 32 patients (53%). In these 17 patients there was a significant correlation between HRT and the other thresholds, but the absolute values for the AT differed considerably: The mean HRT was 132% higher than the AeT according to Beaver, 107% higher than LTP1, and 19% higher than LTP2. Exercise protocols that rely solely on the HRT in CF will lead to excessive exertion during exercise training programs in these patients. According to these results the HRT of Conconi is not a suitable method to determine appropriate exercise levels in CF training programs and might even be harmful in CF patients. These results also indicate the need to test the reliability of a diagnostic procedure that has been developed only for healthy people. © 1998 Wiley‐Liss, Inc. Pediatr. Pulmonol. 1998; 25:147–153.

Background. The impact of the COVID-19 pandemic on population health is recognised as being substantial, yet few studies have attempted to quantify to what extent infection causes mild or moderate symptoms only, requires hospital and/or intensive care unit (ICU) admission, results in prolonged and chronic illness, or leads to premature death. Our objectives were to quantify the total disease burden of acute COVID-19 in the Netherlands in 2020 using the disability-adjusted life-years (DALY) measure, and to investigate how disease burden varies between age-groups and occupation categories.Methods. Using standard methods and diverse data sources (registered COVID-19 deaths, hospital and ICU admissions, population-level seroprevalence, mandatory notifications, and the literature) , we estimated the total years of life lost (YLL), years lived with disability (YLD), DALY and DALY per 100,000 population due to COVID-19, excluding its post-acute sequelae, and additionally stratified by 5-year age-group and occupation.Results. The total disease burden in the Netherlands in 2020 due to acute COVID-19 was 273,500 (95% CI: 268,500–278,800) DALY, and the per-capita burden was 1570 (95% CI: 1540–1600) DALY/100,000, of which 99.4% consisted of YLL. The per-capita burden increased steeply with age, starting from the 60-64 years age-group. The per-capita burden by occupation category was highest for healthcare workers and lowest for the catering sector.Conclusions. SARS-CoV-2 infection and associated premature mortality was responsible for a considerable direct health burden in the Netherlands, despite extensive public health measures. Total DALY were much higher than for other high-burden infectious diseases, but lower than the estimated annual burden from coronary heart disease. These findings are valuable for informing public health decision-makers regarding the expected health burden due to COVID-19 among subgroups of the population, and the possible gains from targeted preventative interventions.

The impact of COVID-19 on population health is recognised as being substantial, yet few studies have attempted to quantify to what extent infection causes mild or moderate symptoms only, requires hospital and/or ICU admission, results in prolonged and chronic illness, or leads to premature death. We aimed to quantify the total disease burden of acute COVID-19 in the Netherlands in 2020 using the disability-adjusted life-years (DALY) measure, and to investigate how burden varies between age-groups and occupations. Using standard methods and diverse data sources (mandatory notifications, population-level seroprevalence, hospital and ICU admissions, registered COVID-19 deaths, and the literature), we estimated years of life lost (YLL), years lived with disability, DALY and DALY per 100,000 population due to COVID-19, excluding post-acute sequelae, stratified by 5-year age-group and occupation category. The total disease burden due to acute COVID-19 was 286,100 (95% CI: 281,700–290,500) DALY, and the per-capita burden was 1640 (95% CI: 1620–1670) DALY/100,000, of which 99.4% consisted of YLL. The per-capita burden increased steeply with age, starting from 60 to 64 years, with relatively little burden estimated for persons under 50 years old. SARS-CoV-2 infection and associated premature mortality was responsible for a considerable direct health burden in the Netherlands, despite extensive public health measures. DALY were much higher than for other high-burden infectious diseases, but lower than estimated for coronary heart disease. These findings are valuable for informing public health decision-makers regarding the expected COVID-19 health burden among population subgroups, and the possible gains from targeted preventative interventions.