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

Abstract

Varicella-Zoster Virus (VZV) belongs to the family Herpesviridae. Herpes zoster (HZ) is caused by reactivation of latent VZV. It is associated with risk factors such as immunosenescence, immunosuppressive pathologies and pharmacological treatments. Patients with these risk factors are more likely to be hospitalized. Increases in HZ hospitalizations have been reported in many countries in recent years. The objective of this study is to estimate hospitalization rates, mortality rates and costs due to HZ during the worst years of the COVID-19 pandemic in Spain (2020–2021). This is a descriptive study based on an analysis of information from the Minimum Basic Dataset and coded according to the Spanish version of the 10th International Classification of Diseases (ICD-10-CM). Hospitalization, mortality and case-fatality rates, and median length of hospitalization were calculated.. The hospitalization rate was 14.4 cases per 100,000 inhabitants, and the mortality rate was 1.3 cases per 100,000 inhabitants. Both increased considerably with age. In this time period, 92.3% of the registered cases were people over 50 years of age. Nevertheless, during the COVID-19 pandemic period, hospitalization rate decreased and the mortality rate increased from previous years. HZ hospitalization and mortality rates are relevant issues in the public health of older people. It is highly recommended to evaluate new vaccination strategies against VZV to include the HZ vaccine for health care for elderly people, as well as to reduce the disease burden and associated risk factors. The estimation of HZ disease hospitalization costs were €100,433,904.

The Burden of Herpes Zoster on Hospital Admissions: A Retrospective Analysis in the Years of 2015–2021 from the Abruzzo Region, Italy

“…For these reasons, it is important to conduct further studies to evaluate the hospitalization rates after the pandemic. In fact, a recent study [21] from Spain has highlighted an increase in HZ-related hospitalizations, also likely due to an association between HZ and SARS-CoV-2.…”

Humoral Cytokine Levels in Patients with Herpes Zoster: A Meta-Analysis

“…Approximately one-third of people are at risk for HZ in their lifetime, and nearly half of people ≥ 85 years old develop HZ. 1 , 2 Zoster-related pain can be classified into acute HZ neuralgia (AHN; within 1 month after the rash) or subacute (SHN; within 3 months after the rash) HZ neuralgia, and postherpetic neuralgia (PHN; more than three months after the rash). 3 The main symptom of PHN is severe and persistent pain, mostly in HZ-infected areas such as the chest, abdomen, face, or neck.…”