Hospitalization Burden Related to Herpes Zoster Infection in Spain (2016–2019)

Abstract

Introduction: Herpes zoster (HZ) and its complications still represent a significant burden for patients and health care systems. In Spain, vaccination is progressively being introduced and recommended for patients between 65 and 80 years old and patients [ 18 years of age suffering from certain immunosuppression conditions. The aim of this study is to estimate the number of hospital admissions related to HZ from 2016 to 2019 in Spain. Methods: Data were collected from the Minimum Basic DataSet (MBDS) and codified according to the Spanish version of the 10th International Classification of Disease (ICD-10-CM codes B02-B02.9). Among others, variables such as sex, age and presence of complications were included. Results: A total of 27,642 hospitalizations were identified (90% in patients [ 50 and 45.8% in patients [ 80). Women represented 51.2% of the patients, and 59.9% of patients presented complications related to HZ. The hospitalization rate was 17.74, the mortality rate was 1.2, and the case fatality rate was 6.75%. All rates were significantly higher with age, among men and in complicated HZ. Immunosuppression status for which vaccination had been recommended represented 22.7% of the total cases, affecting mostly individuals [ 65 and causing more deaths in those [ 80 years. The estimated annual cost of hospitalization for herpes zoster was €35,738,285, and the mean cost per patient was €5172. Conclusion:The hospitalization burden for HZ is still important in Spain. Data on the current epidemiology are important to evaluate future vaccination strategies.

Hospitalization burden related to herpes zoster infection during the COVID-19 pandemic in Spain (2020-2021)

“…Despite a decrease in the hospitalization rate, during the years analyzed, the mortality rate increased. This discrepancy between hospitalization rate and mortality rate does not correspond to the epidemiological reality or to the trend reported by previous studies 11 , 17 , 26 but to factors related to the worst years of the pandemic. The fear of contagion from COVID-19 together with the confinement measures may be some of the causes that delayed visits to emergency rooms.…”

“…This confirms immunosenescence as the main risk factor in the population. 17 , 25 Regarding sex, the number of hospitalizations was higher among women than among men. This difference may not be real and may be because women request more consultations from the health system.…”

“…There was an increase of 25.5% in the case fatality rate, which is a significant change compared to previous studies. 17 This suggests that only the most serious and complicated cases entered into the health system. 36 , 37 The true impact that the SARS-CoV-2 pandemic will have on HZ disease is still unknown.…”

“…A total of 51.7% of the cases were in women, and 59.9% were related to a complicated HZ. 17 For the same period of time, the hospitalization rate for HZ was 17.7 per 100,000 inhabitants (95% CI: 17.53–17.95), the mortality rate was 1.2 deaths per 100,000 inhabitants (95% CI: 1.15–1.25) and the case fatality rate was 6.8% (95% CI: 6.45–7.05). 15 Despite low mortality rates and case fatality rates, HZ generates a significant disease burden for patients and consumes resources for health systems.…”

Comparison of efficacy of acupuncture-related therapy in the treatment of herpes zoster: A network meta-analysis of randomized controlled trials

“…[7] The occurrence of HZ is significantly associated with immunocompromise, hypertension, and diabetes, [7,8] posing huge nursing and economic burden. [9,10] Clinical practice guidelines recommend antiviral therapies to hasten healing time (acyclovir, valacyclovir, famciclovir, and brivudine), [11][12][13][14] and pain management treatments such as paracetamol/acetaminophen, opioid analgesics, tricyclic antidepressants and anticonvulsants for significant pain, but the therapeutic effects are far from satisfying and there is limited evidence in reducing the incidence of PHN. [15] One study using the Treatment Satisfaction Questionnaire for Medication (TSQM, Version II) to assess patient satisfaction with HZ treatment showed that patient satisfaction was highest in the "side effects" area of TSQM and lowest in the "effectiveness" area.…”