Enhanced national surveillance of severe acute respiratory infections (SARI) within COVID-19 surveillance, Slovenia, weeks 13 to 37 2021

Klavs, Irena; Serdt, Mojca; Učakar, Veronika; Grgič-Vitek, Marta; Fafangel, Mario; Mrzel, Maja; Berlot, Lina; Glavan, Uroš; Vrh, Marjana; Kustec, Tanja; Simoniti, Miha; Kevorkijan, Božena Kotnik; Zupanc, Tatjana Lejko

doi:10.2807/1560-7917.es.2021.26.42.2100937

Cited by 8 publications

(25 citation statements)

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“…A SARI COVID-19 case was defined as an individual with SARI and a positive SARS-CoV-2 reverse transcription PCR (RT-PCR) or antigen test result at admission to hospital [ 2 ]. A case with a previous COVID-19 diagnosis was defined as an individual with a record of a positive SARS-CoV-2 RT-PCR in the national COVID-19 database more than 3 weeks before the week under observation.…”

Section: Case Definitions and Other Definitionsmentioning

confidence: 99%

“…Three different sources were used in the analysis: (i) weekly numbers of SARI COVID-19 cases admitted to hospitals were extracted from EPISARI [ 2 ], (ii) vaccination status of all individuals vaccinated in Slovenia was obtained from the national Electronic registry of vaccinated individuals and adverse events following immunisation (eRCO) [ 3 ] and (iii) previous diagnosis of COVID-19 was retrieved from the national COVID-19 database. By using unique national identifiers, we were able to link the data from the three databases to ascertain the vaccination status of SARI COVID-19 cases admitted to hospitals and previous diagnosis of COVID-19 among fully vaccinated individuals.…”

Section: Data Sourcesmentioning

confidence: 99%

“… CI: confidence interval; COVID-19: coronavirus disease; mRNA: messenger ribonucleic acid; SARI: severe acute respiratory infection; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2. a Individuals without previous COVID-19 diagnosis were defined as individuals without a record of a positive SARS-CoV-2 RT-PCR in the national COVID-19 database more than 3 weeks before the week under observation within the SARI surveillance database known as EPISARI [ 2 ]. b Fully vaccinated individuals with any vaccine were defined as individuals who had received two doses of mRNA vaccines (Comirnaty (BNT162b2 mRNA, BioNTech-Pfizer, Mainz, Germany/New York, United States) or Spikevax (mRNA-1273, Moderna, Cambridge, United States)) or viral vector vaccine (Vaxzervia (ChAdOx1 nCoV-19, Oxford-AstraZeneca, Cambridge, United Kingdom)) or one dose of viral vector vaccine Janssen (Ad26.COV2-S, Janssen-Cilag International NV, Beerse, Belgium) at least 14 days before the week under observation.…”

Section: Vaccine Effectiveness Against Sari Covid-19 Hospitalisationsmentioning

confidence: 99%

“…d SARI COVID-19 cases were defined as all SARI cases testing positive for SARS-CoV-2 by PCR or antigen test at admission to hospitals. Data sources: EPISARI surveillance of severe acute respiratory infections within comprehensive COVID-19 surveillance [ 2 ], national electronic registry of vaccinated individuals and adverse events following vaccinations (eRCO), national COVID-19 dataset and Slovenian Central Population Registry.…”

Section: Vaccine Effectiveness Against Sari Covid-19 Hospitalisationsmentioning

confidence: 99%

“…Vaccine effectiveness for all vaccine types, mRNA vaccines and viral vector vaccines, against hospitalisation due to SARI COVID-19, by age group, Slovenia, October 2021 Individuals without previous COVID-19 diagnosis were defined as individuals without a record of a positive SARS-CoV-2 RT-PCR in the national COVID-19 database more than 3 weeks before the week under observation within the SARI surveillance database known as EPISARI[2]. b Fully vaccinated individuals with any vaccine were defined as individuals who had received two doses of mRNA vaccines (Comirnaty Unvaccinated individuals were defined as individuals who had not received any dose of vaccine against COVID-19.…”

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confidence: 99%

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Vaccine effectiveness against severe acute respiratory infections (SARI) COVID-19 hospitalisations estimated from real-world surveillance data, Slovenia, October 2021

et al. 2022

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We estimated vaccine effectiveness (VE) against severe COVID-19 during October 2021, using Slovenian surveillance data. For people fully vaccinated with any vaccine in age groups 18–49, 50–64, ≥ 65 years, VE was 86% (95% CI: 79–90), 89% (85–91), and 77% (74–81). Among ≥ 65 year-olds fully vaccinated with mRNA vaccines, VE decreased from 93% (95% CI: 88–96) in those vaccinated ≤ 3 months ago to 43% (95% CI: 30–54) in those vaccinated ≥ 6 months ago, suggesting the need for early boosters.

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Section: Case Definitions and Other Definitionsmentioning

confidence: 99%

Section: Data Sourcesmentioning

confidence: 99%

Section: Vaccine Effectiveness Against Sari Covid-19 Hospitalisationsmentioning

confidence: 99%

Section: Vaccine Effectiveness Against Sari Covid-19 Hospitalisationsmentioning

confidence: 99%

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confidence: 99%

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Vaccine effectiveness against severe acute respiratory infections (SARI) COVID-19 hospitalisations estimated from real-world surveillance data, Slovenia, October 2021

et al. 2022

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ICD-10 based syndromic surveillance enables robust estimation of burden of severe COVID-19 requiring hospitalization and intensive care treatment

Tolksdorf

Haas

Schuler

et al. 2022

Preprint

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Objective: With the emergence of coronavirus disease 2019 (COVID-19) countries had to establish COVID-19 surveillance by adapting existing systems, such as the mandatory notification system and syndromic surveillance systems. We estimated COVID-19 hospitalization and ICU burden from existing severe acute respiratory infections (SARI) surveillance and compared it to COVID-19 notification data. Methods: Using data from the ICD-10 based hospital sentinel, we estimated SARI incidence and validated our estimations retrospectively using full population data. We estimated age-specific incidences for COVID-19 hospitalization and ICU for the first three COVID-19 waves in Germany, based on information of SARI cases (COVID-SARI). We compared these estimations to hospitalization and ICU burden of COVID-19 from notification data and described potential underreporting of hospitalizations in notification data. Findings: The estimation of SARI incidence from sentinel data corresponded very well to full population data. The estimated COVID-SARI incidence matched the notified COVID-19 hospitalization incidence in the first wave, but was much higher during the second and the third wave. The proportion of unknown hospitalization status among notified COVID-19 cases was much higher in the later waves compared to the first wave. For all waves, the ICU incidence estimated from COVID-SARI was considerably higher than the results from notification data. Conclusion: The use of SARI sentinel data adds valid and important information for assessing COVID-19 hospitalization and ICU burden, especially in times with high case numbers where notification data may be more incomplete.

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Characteristics and outcomes of COVID-19 patients during B.1.1.529 (Omicron) dominance compared to B.1.617.2 (Delta) in 89 German hospitals

Leiner

Pellissier

Hohenstein

et al. 2022

Preprint

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Background: The SARS-CoV-2 variant of concern B.1.1.529 (Omicron) was first described in November 2021 and soon became the dominant variant worldwide. Existing data suggests a reduced disease severity in comparison to B.1.617.2 (Delta). Differences in characteristics and in-hospital outcomes of patients with COVID-19 in Germany during the Omicron period compared to Delta are not thoroughly studied. Surveillance for severe acute respiratory infections (SARI) represents an integral part of infectious disease control in Germany. Methods: Administrative data from 89 German Helios hospitals was retrospectively analysed. Laboratory-confirmed SARS-CoV-2 infections were identified by ICD-10-code U07.1 and SARI cases by ICD-10-codes J09-J22. COVID-19 cases were stratified by concomitant SARI. A nine-week observational period between December 6, 2021 and February 6, 2022 was defined and divided into three phases with respect to the dominating virus variant (Delta, Delta to Omicron transition, Omicron). Regression analyses adjusted for age, gender and Elixhauser comorbidities were applied to assess in-hospital patient outcomes. Results: A total cohort of 4,494 inpatients was analysed. Patients in the Omicron dominance period were younger (mean age 61.6 vs. 47.8; p<0.01), more likely to be female (54.7% vs. 47.5%; p<0.01) and characterized by a lower comorbidity burden (mean Elixhauser comorbidity index 8.2 vs. 5.4; p<0.01). Comparing Delta and Omicron periods, patients were at significantly lower risk for intensive care treatment (adjusted odds ratio 0.64 [0.51-0.8]; p<0.001), mechanical ventilation (adjusted odds ratio 0.38 [0.28-0.51]; p<0.001), and in-hospital mortality (adjusted odds ratio 0.42 [0.32-0.56]; p<0.001). This also applied to the separate COVID-SARI group. During the Delta to Omicron transition, case numbers of COVID-19 without SARI exceeded COVID-SARI. Conclusion: Patient characteristics and outcomes differ during the Omicron dominance period as compared to Delta suggesting a reduced disease severity with Omicron infections. SARI surveillance might play a crucial role in assessing disease severity of future SARS-CoV-2 variants.

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Enhanced national surveillance of severe acute respiratory infections (SARI) within COVID-19 surveillance, Slovenia, weeks 13 to 37 2021

Cited by 8 publications

References 1 publication

Vaccine effectiveness against severe acute respiratory infections (SARI) COVID-19 hospitalisations estimated from real-world surveillance data, Slovenia, October 2021

Vaccine effectiveness against severe acute respiratory infections (SARI) COVID-19 hospitalisations estimated from real-world surveillance data, Slovenia, October 2021

ICD-10 based syndromic surveillance enables robust estimation of burden of severe COVID-19 requiring hospitalization and intensive care treatment

Characteristics and outcomes of COVID-19 patients during B.1.1.529 (Omicron) dominance compared to B.1.617.2 (Delta) in 89 German hospitals

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