Influenza in Adults Seeking Care at Seven European Emergency Departments: A Prospective Active Surveillance During the 2019–2020 Influenza Season
ABSTRACT Background Influenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing for influenza in the healthcare system, especially if patients do not present with influenza‐like illness (ILI). We aimed to measure the pro...
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| Vydáno v: | Influenza and other respiratory viruses Ročník 18; číslo 11; s. e70040 - n/a |
|---|---|
| Hlavní autoři: | , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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England
John Wiley & Sons, Inc
01.11.2024
Wiley Open Access John Wiley and Sons Inc |
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| ISSN: | 1750-2640, 1750-2659, 1750-2659 |
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| Abstract | ABSTRACT
Background
Influenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing for influenza in the healthcare system, especially if patients do not present with influenza‐like illness (ILI). We aimed to measure the proportion of influenza cases seeking care at emergency department (ED) for a nontraumatic cause, to describe their clinical presentation and their ED‐discharge diagnosis.
Methods
The study was conducted at seven hospitals in France, Spain, Italy and Germany during the 2019–20 influenza season, for a period of 10 weeks. Patients (≥ 18 years) consulting for nontraumatic causes at the ED were invited to participate. Consenting patients provided upper respiratory swab samples for influenza testing by reverse transcription polymerase chain reaction. Clinical and demographic data were collected.
Results
There were 8678 patients included, 50.7% were female and the median age was 57 years. Among them, 494 (5.7%) were laboratory‐confirmed influenza (LCI) cases. Nonetheless, only 24.3% of LCI cases had an ED‐discharge of influenza. Of all cases confirmed as influenza, 47.6% had a nonrespiratory discharge diagnosis, which frequency increased with age. ILI case definition from the European Centre for Disease Prevention and Control was the most frequently met among influenza cases (68.6%). Older patients (≥ 65 years) were less frequently identified based on any ILI signs/symptoms.
Conclusion
Our findings indicate that the impact of influenza among patients seeking care at the ED cannot be easily assessed based on clinical presentation and medical records alone. Preventing influenza among adult population may reduce healthcare utilization. |
|---|---|
| AbstractList | ABSTRACT
Background
Influenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing for influenza in the healthcare system, especially if patients do not present with influenza‐like illness (ILI). We aimed to measure the proportion of influenza cases seeking care at emergency department (ED) for a nontraumatic cause, to describe their clinical presentation and their ED‐discharge diagnosis.
Methods
The study was conducted at seven hospitals in France, Spain, Italy and Germany during the 2019–20 influenza season, for a period of 10 weeks. Patients (≥ 18 years) consulting for nontraumatic causes at the ED were invited to participate. Consenting patients provided upper respiratory swab samples for influenza testing by reverse transcription polymerase chain reaction. Clinical and demographic data were collected.
Results
There were 8678 patients included, 50.7% were female and the median age was 57 years. Among them, 494 (5.7%) were laboratory‐confirmed influenza (LCI) cases. Nonetheless, only 24.3% of LCI cases had an ED‐discharge of influenza. Of all cases confirmed as influenza, 47.6% had a nonrespiratory discharge diagnosis, which frequency increased with age. ILI case definition from the European Centre for Disease Prevention and Control was the most frequently met among influenza cases (68.6%). Older patients (≥ 65 years) were less frequently identified based on any ILI signs/symptoms.
Conclusion
Our findings indicate that the impact of influenza among patients seeking care at the ED cannot be easily assessed based on clinical presentation and medical records alone. Preventing influenza among adult population may reduce healthcare utilization. Influenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing for influenza in the healthcare system, especially if patients do not present with influenza-like illness (ILI). We aimed to measure the proportion of influenza cases seeking care at emergency department (ED) for a nontraumatic cause, to describe their clinical presentation and their ED-discharge diagnosis. The study was conducted at seven hospitals in France, Spain, Italy and Germany during the 2019-20 influenza season, for a period of 10 weeks. Patients (≥ 18 years) consulting for nontraumatic causes at the ED were invited to participate. Consenting patients provided upper respiratory swab samples for influenza testing by reverse transcription polymerase chain reaction. Clinical and demographic data were collected. There were 8678 patients included, 50.7% were female and the median age was 57 years. Among them, 494 (5.7%) were laboratory-confirmed influenza (LCI) cases. Nonetheless, only 24.3% of LCI cases had an ED-discharge of influenza. Of all cases confirmed as influenza, 47.6% had a nonrespiratory discharge diagnosis, which frequency increased with age. ILI case definition from the European Centre for Disease Prevention and Control was the most frequently met among influenza cases (68.6%). Older patients (≥ 65 years) were less frequently identified based on any ILI signs/symptoms. Our findings indicate that the impact of influenza among patients seeking care at the ED cannot be easily assessed based on clinical presentation and medical records alone. Preventing influenza among adult population may reduce healthcare utilization. ABSTRACT Background Influenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing for influenza in the healthcare system, especially if patients do not present with influenza‐like illness (ILI). We aimed to measure the proportion of influenza cases seeking care at emergency department (ED) for a nontraumatic cause, to describe their clinical presentation and their ED‐discharge diagnosis. Methods The study was conducted at seven hospitals in France, Spain, Italy and Germany during the 2019–20 influenza season, for a period of 10 weeks. Patients (≥ 18 years) consulting for nontraumatic causes at the ED were invited to participate. Consenting patients provided upper respiratory swab samples for influenza testing by reverse transcription polymerase chain reaction. Clinical and demographic data were collected. Results There were 8678 patients included, 50.7% were female and the median age was 57 years. Among them, 494 (5.7%) were laboratory‐confirmed influenza (LCI) cases. Nonetheless, only 24.3% of LCI cases had an ED‐discharge of influenza. Of all cases confirmed as influenza, 47.6% had a nonrespiratory discharge diagnosis, which frequency increased with age. ILI case definition from the European Centre for Disease Prevention and Control was the most frequently met among influenza cases (68.6%). Older patients (≥ 65 years) were less frequently identified based on any ILI signs/symptoms. Conclusion Our findings indicate that the impact of influenza among patients seeking care at the ED cannot be easily assessed based on clinical presentation and medical records alone. Preventing influenza among adult population may reduce healthcare utilization. Influenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing for influenza in the healthcare system, especially if patients do not present with influenza-like illness (ILI). We aimed to measure the proportion of influenza cases seeking care at emergency department (ED) for a nontraumatic cause, to describe their clinical presentation and their ED-discharge diagnosis.BACKGROUNDInfluenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing for influenza in the healthcare system, especially if patients do not present with influenza-like illness (ILI). We aimed to measure the proportion of influenza cases seeking care at emergency department (ED) for a nontraumatic cause, to describe their clinical presentation and their ED-discharge diagnosis.The study was conducted at seven hospitals in France, Spain, Italy and Germany during the 2019-20 influenza season, for a period of 10 weeks. Patients (≥ 18 years) consulting for nontraumatic causes at the ED were invited to participate. Consenting patients provided upper respiratory swab samples for influenza testing by reverse transcription polymerase chain reaction. Clinical and demographic data were collected.METHODSThe study was conducted at seven hospitals in France, Spain, Italy and Germany during the 2019-20 influenza season, for a period of 10 weeks. Patients (≥ 18 years) consulting for nontraumatic causes at the ED were invited to participate. Consenting patients provided upper respiratory swab samples for influenza testing by reverse transcription polymerase chain reaction. Clinical and demographic data were collected.There were 8678 patients included, 50.7% were female and the median age was 57 years. Among them, 494 (5.7%) were laboratory-confirmed influenza (LCI) cases. Nonetheless, only 24.3% of LCI cases had an ED-discharge of influenza. Of all cases confirmed as influenza, 47.6% had a nonrespiratory discharge diagnosis, which frequency increased with age. ILI case definition from the European Centre for Disease Prevention and Control was the most frequently met among influenza cases (68.6%). Older patients (≥ 65 years) were less frequently identified based on any ILI signs/symptoms.RESULTSThere were 8678 patients included, 50.7% were female and the median age was 57 years. Among them, 494 (5.7%) were laboratory-confirmed influenza (LCI) cases. Nonetheless, only 24.3% of LCI cases had an ED-discharge of influenza. Of all cases confirmed as influenza, 47.6% had a nonrespiratory discharge diagnosis, which frequency increased with age. ILI case definition from the European Centre for Disease Prevention and Control was the most frequently met among influenza cases (68.6%). Older patients (≥ 65 years) were less frequently identified based on any ILI signs/symptoms.Our findings indicate that the impact of influenza among patients seeking care at the ED cannot be easily assessed based on clinical presentation and medical records alone. Preventing influenza among adult population may reduce healthcare utilization.CONCLUSIONOur findings indicate that the impact of influenza among patients seeking care at the ED cannot be easily assessed based on clinical presentation and medical records alone. Preventing influenza among adult population may reduce healthcare utilization. |
| Author | Rubio, Alberto Perez Pozo Vegas, Carlos Loebermann, Micha Oppert, Michael Tazarourte, Karim Glass, Andrea Amour, Sélilah Bricout, Hélène Walker, Jonas Jacquin, Laurent Icardi, Giancarlo Chaves, Sandra S. Orsi, Andrea Nealon, Joshua Douplat, Marion Vanhems, Philippe |
| AuthorAffiliation | 3 Dirección Médica Hospital Clínico Universitario de Valladolid Valladolid Spain 10 Sanofi Vaccines Campus Sanofi Lyon Lyon France 7 Service d'Accueil des Urgences Hospices Civils de Lyon Lyon France 5 Klinik für Notfall‐ und Internistische Intensivmedizin Klinikum Ernst von Bergmann Potsdam Germany 9 INSERM UMR1060 (CarMeN), Ischemia‐Reperfusion Syndromes (IRIS) Université Lyon 1 Bron France 2 Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases (PHE3ID), Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, ENS de Lyon Université de Lyon 1 Lyon France 6 Abteilung für Tropenmedizin und Infektionskrankheiten und Sektion Nephrologie Universitätsmedizin Rostock Rostock Germany 1 Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention Hospices Civils de Lyon Lyon France 4 Department of Health Sciences University of Genoa Genoa Italy 8 Research on Healthcare Performance (RESHAPE), INSERM U1290 Université Claude Bernard Lyon 1 Lyon Fr |
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| Author_xml | – sequence: 1 givenname: Sélilah orcidid: 0000-0002-4804-7209 surname: Amour fullname: Amour, Sélilah email: selilah.amour@chu‐lyon.fr organization: Université de Lyon 1 – sequence: 2 givenname: Alberto Perez surname: Rubio fullname: Rubio, Alberto Perez organization: Hospital Clínico Universitario de Valladolid – sequence: 3 givenname: Andrea surname: Orsi fullname: Orsi, Andrea organization: University of Genoa – sequence: 4 givenname: Michael surname: Oppert fullname: Oppert, Michael organization: Klinikum Ernst von Bergmann – sequence: 5 givenname: Micha surname: Loebermann fullname: Loebermann, Micha organization: Universitätsmedizin Rostock – sequence: 6 givenname: Carlos surname: Pozo Vegas fullname: Pozo Vegas, Carlos organization: Hospital Clínico Universitario de Valladolid – sequence: 7 givenname: Karim surname: Tazarourte fullname: Tazarourte, Karim organization: Université Claude Bernard Lyon 1 – sequence: 8 givenname: Marion surname: Douplat fullname: Douplat, Marion organization: Université Claude Bernard Lyon 1 – sequence: 9 givenname: Laurent surname: Jacquin fullname: Jacquin, Laurent organization: Université Lyon 1 – sequence: 10 givenname: Giancarlo surname: Icardi fullname: Icardi, Giancarlo organization: University of Genoa – sequence: 11 givenname: Jonas surname: Walker fullname: Walker, Jonas organization: Klinikum Ernst von Bergmann – sequence: 12 givenname: Andrea surname: Glass fullname: Glass, Andrea organization: Universitätsmedizin Rostock – sequence: 13 givenname: Joshua surname: Nealon fullname: Nealon, Joshua organization: Campus Sanofi Lyon – sequence: 14 givenname: Sandra S. surname: Chaves fullname: Chaves, Sandra S. organization: Campus Sanofi Lyon – sequence: 16 givenname: Hélène orcidid: 0000-0002-5439-8064 surname: Bricout fullname: Bricout, Hélène organization: Campus Sanofi Lyon – sequence: 17 givenname: Philippe orcidid: 0000-0003-3188-1456 surname: Vanhems fullname: Vanhems, Philippe organization: Université de Lyon 1 |
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| Copyright | 2024 The Author(s). published by John Wiley & Sons Ltd. 2024 The Author(s). Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd. 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Distributed under a Creative Commons Attribution 4.0 International License |
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| Keywords | influenza emergency department (ED) influenza‐like illness (ILI) International Classification of Diseases (ICD) diagnosis |
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| References_xml | – volume: 9 start-page: 251 issue: 3 year: 2021 end-page: 259 article-title: Comparison of the Characteristics, Morbidity, and Mortality of COVID‐19 and Seasonal Influenza: A Nationwide, Population‐Based Retrospective Cohort Study publication-title: Lancet Respiratory Medicine – volume: 14 issue: 4 year: 2022 article-title: Contribution of Influenza Viruses, Other Respiratory Viruses and Viral Co‐Infections to Influenza‐Like Illness in Older Adults publication-title: Viruses – volume: 16 issue: 1 year: 2016 article-title: Predictors of Influenza Among Older Adults in the Emergency Department publication-title: BMC Infectious Diseases – volume: 371 year: 2020 article-title: Comparative Evaluation of Clinical Manifestations and Risk of Death in Patients Admitted to Hospital With Covid‐19 and Seasonal Influenza: Cohort Study publication-title: BMJ – volume: 36 start-page: 241 issue: 3 year: 2015 end-page: 248 article-title: Clinical Predictors for Laboratory‐Confirmed Influenza Infections: Exploring Case Definitions for Influenza‐Like Illness publication-title: Infection Control and Hospital Epidemiology – volume: 96 start-page: 122 issue: 2 year: 2018 end-page: 128 article-title: Revision of Clinical Case Definitions: Influenza‐Like Illness and Severe Acute Respiratory Infection publication-title: Bulletin of the World Health Organization – volume: 391 start-page: 1285 issue: 10127 year: 2018 end-page: 1300 article-title: Estimates of Global Seasonal Influenza‐Associated Respiratory Mortality: A Modelling Study publication-title: Lancet – volume: 161 start-page: 2116 issue: 17 year: 2001 end-page: 2122 article-title: Diagnosis of Influenza in the Community: Relationship of Clinical Diagnosis to Confirmed Virological, Serologic, or Molecular Detection of Influenza publication-title: Archives of Internal Medicine – volume: 216 start-page: 415 issue: 4 year: 2017 end-page: 424 article-title: Influenza‐Like Illness Incidence Is Not Reduced by Influenza Vaccination in a Cohort of Older Adults, Despite Effectively Reducing Laboratory‐Confirmed Influenza Virus Infections publication-title: Journal of Infectious Diseases – year: 2018 – year: 1992 – volume: 35 start-page: 65 issue: 2 year: 2007 end-page: 68 article-title: Lack of Discriminating Signs and Symptoms in Clinical Diagnosis of Influenza of Patients Admitted to the Hospital publication-title: Infection – volume: 16 start-page: 371 issue: 3 year: 2022 end-page: 375 article-title: Validation of International Classification of Diseases Criteria to Identify Severe Influenza Hospitalizations publication-title: Influenza and Other Respiratory Viruses – volume: 33 start-page: 1064 issue: 10 year: 2012 end-page: 1066 article-title: Surveillance for Influenza Using Hospital Discharge Data May Underestimate the Burden of Influenza‐Related Hospitalization publication-title: Infection Control and Hospital Epidemiology – volume: 2 start-page: 63 issue: 1 year: 2013 end-page: 66 article-title: Use of Administrative Data for the Identification of Laboratory‐Confirmed Influenza Infection: The Validity of Influenza‐Specific ICD‐9 Codes publication-title: Journal of the Pediatric Infectious Diseases Society – volume: 21 issue: 1 year: 2021 article-title: Evaluation of the Accuracy of Diagnostic Coding for Influenza Compared to Laboratory Results: The Availability of Test Results Before Hospital Discharge Facilitates Improved Coding Accuracy publication-title: BMC Medical Informatics and Decision Making – volume: 16 start-page: 47 issue: 1 year: 2018 end-page: 60 article-title: The Evolution of Seasonal Influenza Viruses publication-title: Nature Reviews. 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Background
Influenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing... Influenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing for influenza in... ABSTRACT Background Influenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing... |
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| Title | Influenza in Adults Seeking Care at Seven European Emergency Departments: A Prospective Active Surveillance During the 2019–2020 Influenza Season |
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