Age and Sex Differences in Rates of Influenza-Associated Hospitalizations in Hong Kong

Wang, Xi Ling; Lin, Yong; Chan, Kwok Hung; Chan, King Pan; Cao, Pei Hua; Lau, Eric H. Y.; Peiris, Malik; Wong, Chit Ming

doi:10.1093/aje/kwv068

Cited by 65 publications

(43 citation statements)

References 42 publications

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“…Overall, seasonal P&I excess hospitalization rates were higher among the individuals with <2 years and among those with 65 or more years of age. These results are compatible with those published in other studies that include these two groups at higher risk of being hospitalized during influenza seasonal epidemics . Nevertheless, this pattern was not equal in all seasons, specifically during the pandemic A(H1)pdm09 season, where no excess P&I hospitalizations were observed among the elderly (≥65 years).…”

Section: Discussionsupporting

confidence: 91%

Excess pneumonia and influenza hospitalizations associated with influenza epidemics in Portugal from season 1998/1999 to 2014/2015

Rodrigues

Machado

Silva

et al. 2018

Influenza Resp Viruses

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BackgroundThe aim of this study was to estimate excess pneumonia and influenza (P&I) hospitalizations during influenza epidemics and measure their correlation with influenza vaccine coverage in the 65 and more years old, according to the type/subtype of influenza virus.MethodsThe study period comprised week 40/1998‐40/2015. Age‐specific weekly P&I hospitalizations (ICD‐9: 480‐487) as main diagnosis were extracted from the National Hospital Discharge database. Age‐specific baseline hospitalization rates were estimated by autoregressive integrated moving average (ARIMA) model without time periods with excess hospitalizations. Excess hospitalizations were calculated by subtracting expected hospitalization rates from the observed during influenza epidemic periods. Correlation between excess P&I hospitalizations and influenza vaccine coverage in the elderly was measured with Pearson correlation coefficient.ResultsThe average excess P&I hospitalizations/season was 19.4/105 (range 0‐46.1/105), and higher excess was observed in young children with <2 years (79.8/105) and ≥65 years (68.3/105). In epidemics with A(H3) dominant, the highest excess hospitalizations were observed among 65 and over. Seasons which influenza B or A(H1)pdm09 dominance the highest excess was observed in children with <2 years. High negative correlation was estimated between excess hospitalizations associated with A(H3) circulation and vaccine coverage in the elderly (r = −.653; 95% CI: −0.950 to −0.137).ConclusionOver 80% of the influenza epidemics were associated with excess hospitalizations. However, excess P&I hospitalizations pattern differed from age group and circulating virus. This ecologic approach also identified a reduction in excess P&I associated with A(H3) circulation with increasing vaccine coverage in the elderly.

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Section: Discussionsupporting

confidence: 91%

Excess pneumonia and influenza hospitalizations associated with influenza epidemics in Portugal from season 1998/1999 to 2014/2015

Rodrigues

Machado

Silva

et al. 2018

Influenza Resp Viruses

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“…Consistent with previous findings on sex differences in influenza-associated hospitalization, 24 only limited evidence of a sex difference in influenza-associated mortality was found. In general, males tended to show a higher risk of death associated with influenza infection than females.…”

Section: Discussionsupporting

confidence: 90%

Excess mortality associated with influenza after the 2009 H1N1 pandemic in a subtropical city in China, 2010–2015

Liu

Qin

et al. 2017

International Journal of Infectious Diseases

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“…Following duplicate removal (N = 946) and the screening of titles and abstracts (N = 5787), a total of 43 records were deemed to be worthy of further evaluation and the corresponding full texts were assessed. Of these, 16 papers met all inclusion criteria and were included. In the study by Caini et al only 12 of 26 study locations had a sufficient number (≥100) of isolates among the elderly.…”

Section: Resultsmentioning

confidence: 99%

Heterogeneous estimates of influenza virus types A and B in the elderly: Results of a meta‐regression analysis

Panatto

Signori

Lai

et al. 2018

Influenza Resp Viruses

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Influenza has many age‐dependent characteristics. A previous systematic review of randomized controlled trials showed that the detection rate of influenza B was higher in children than in non‐elderly adults. However, no comprehensive reviews have targeted the elderly, who carry the main burden of disease. We aimed to quantify the relative detection rates of virus types A and B among the elderly, to identify factors affecting these proportions, and to compare type distribution among seniors and younger age‐classes. A comprehensive literature search was conducted to identify multiseason studies reporting A and B virus type distributions in the elderly. A random‐effects meta‐analysis was planned to quantify the prevalence of type B among elderly subjects with laboratory‐confirmed influenza. Meta‐regression was then applied to explain the sources of heterogeneity. Across 27 estimates identified, the type B detection rate among seniors varied from 5% to 37%. Meta‐analysis was not feasible owing to high heterogeneity (I 2 = 98.5%). Meta‐regression analysis showed that study characteristics, such as number of seasons included, hemisphere, and setting, could have contributed to the heterogeneity observed. The final adjusted model showed that studies that included both outpatients and inpatients reported a significantly (P = .024) lower proportion than those involving outpatients only. The detection rate of type B among the elderly was generally lower than in children/adolescents, but not non‐elderly adults. Influenza virus type B has a relatively low detection rate in older adults, especially in settings covering both inpatients and outpatients. Public health implications are discussed.

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Age and Sex Differences in Rates of Influenza-Associated Hospitalizations in Hong Kong

Cited by 65 publications

References 42 publications

Excess pneumonia and influenza hospitalizations associated with influenza epidemics in Portugal from season 1998/1999 to 2014/2015

Excess pneumonia and influenza hospitalizations associated with influenza epidemics in Portugal from season 1998/1999 to 2014/2015

Excess mortality associated with influenza after the 2009 H1N1 pandemic in a subtropical city in China, 2010–2015

Heterogeneous estimates of influenza virus types A and B in the elderly: Results of a meta‐regression analysis

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