Incidence of community acquired lower respiratory tract disease in Bristol, UK during the COVID-19 pandemic: A prospective cohort study
The emergence of COVID-19 and public health measures implemented to reduce SARS-CoV-2 infections have both affected acute lower respiratory tract disease (aLRTD) epidemiology and incidence trends. The severity of COVID-19 and non-SARS-CoV-2 aLRTD during this period have not been compared in detail....
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Published in | The Lancet regional health. Europe Vol. 21; p. 100473 |
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Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
Elsevier Ltd
01.10.2022
Elsevier |
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Abstract | The emergence of COVID-19 and public health measures implemented to reduce SARS-CoV-2 infections have both affected acute lower respiratory tract disease (aLRTD) epidemiology and incidence trends. The severity of COVID-19 and non-SARS-CoV-2 aLRTD during this period have not been compared in detail.
We conducted a prospective cohort study of adults age ≥18 years admitted to either of two acute care hospitals in Bristol, UK, from August 2020 to November 2021. Patients were included if they presented with signs or symptoms of aLRTD (e.g., cough, pleurisy), or a clinical or radiological aLRTD diagnosis.
12,557 adult aLRTD hospitalisations occurred: 10,087 were associated with infection (pneumonia or non-pneumonic lower respiratory tract infection [NP-LRTI]), 2161 with no infective cause, with 306 providing a minimal surveillance dataset. Confirmed SARS-CoV-2 infection accounted for 32% (3178/10,087) of respiratory infections. Annual incidences of overall, COVID-19, and non- SARS-CoV-2 pneumonia were 714.1, 264.2, and 449.9, and NP-LRTI were 346.2, 43.8, and 302.4 per 100,000 adults, respectively. Weekly incidence trends in COVID-19 aLRTD showed large surges (median 6.5 [IQR 0.7–10.2] admissions per 100,000 adults per week), while other infective aLRTD events were more stable (median 14.3 [IQR 12.8–16.4] admissions per 100,000 adults per week) as were non-infective aLRTD events (median 4.4 [IQR 3.5–5.5] admissions per 100,000 adults per week).
While COVID-19 disease was a large component of total aLRTD during this pandemic period, non- SARS-CoV-2 infection still caused the majority of respiratory infection hospitalisations. COVID-19 disease showed significant temporal fluctuations in frequency, which were less apparent in non-SARS-CoV-2 infection. Despite public health interventions to reduce respiratory infection, disease incidence remains high.
AvonCAP is an investigator-led project funded under a collaborative agreement by Pfizer. |
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AbstractList | Background: The emergence of COVID-19 and public health measures implemented to reduce SARS-CoV-2 infections have both affected acute lower respiratory tract disease (aLRTD) epidemiology and incidence trends. The severity of COVID-19 and non-SARS-CoV-2 aLRTD during this period have not been compared in detail. Methods: We conducted a prospective cohort study of adults age ≥18 years admitted to either of two acute care hospitals in Bristol, UK, from August 2020 to November 2021. Patients were included if they presented with signs or symptoms of aLRTD (e.g., cough, pleurisy), or a clinical or radiological aLRTD diagnosis. Findings: 12,557 adult aLRTD hospitalisations occurred: 10,087 were associated with infection (pneumonia or non-pneumonic lower respiratory tract infection [NP-LRTI]), 2161 with no infective cause, with 306 providing a minimal surveillance dataset. Confirmed SARS-CoV-2 infection accounted for 32% (3178/10,087) of respiratory infections. Annual incidences of overall, COVID-19, and non- SARS-CoV-2 pneumonia were 714.1, 264.2, and 449.9, and NP-LRTI were 346.2, 43.8, and 302.4 per 100,000 adults, respectively. Weekly incidence trends in COVID-19 aLRTD showed large surges (median 6.5 [IQR 0.7–10.2] admissions per 100,000 adults per week), while other infective aLRTD events were more stable (median 14.3 [IQR 12.8–16.4] admissions per 100,000 adults per week) as were non-infective aLRTD events (median 4.4 [IQR 3.5–5.5] admissions per 100,000 adults per week). Interpretation: While COVID-19 disease was a large component of total aLRTD during this pandemic period, non- SARS-CoV-2 infection still caused the majority of respiratory infection hospitalisations. COVID-19 disease showed significant temporal fluctuations in frequency, which were less apparent in non-SARS-CoV-2 infection. Despite public health interventions to reduce respiratory infection, disease incidence remains high. Funding: AvonCAP is an investigator-led project funded under a collaborative agreement by Pfizer. The emergence of COVID-19 and public health measures implemented to reduce SARS-CoV-2 infections have both affected acute lower respiratory tract disease (aLRTD) epidemiology and incidence trends. The severity of COVID-19 and non-SARS-CoV-2 aLRTD during this period have not been compared in detail. We conducted a prospective cohort study of adults age ≥18 years admitted to either of two acute care hospitals in Bristol, UK, from August 2020 to November 2021. Patients were included if they presented with signs or symptoms of aLRTD (e.g., cough, pleurisy), or a clinical or radiological aLRTD diagnosis. 12,557 adult aLRTD hospitalisations occurred: 10,087 were associated with infection (pneumonia or non-pneumonic lower respiratory tract infection [NP-LRTI]), 2161 with no infective cause, with 306 providing a minimal surveillance dataset. Confirmed SARS-CoV-2 infection accounted for 32% (3178/10,087) of respiratory infections. Annual incidences of overall, COVID-19, and non- SARS-CoV-2 pneumonia were 714.1, 264.2, and 449.9, and NP-LRTI were 346.2, 43.8, and 302.4 per 100,000 adults, respectively. Weekly incidence trends in COVID-19 aLRTD showed large surges (median 6.5 [IQR 0.7–10.2] admissions per 100,000 adults per week), while other infective aLRTD events were more stable (median 14.3 [IQR 12.8–16.4] admissions per 100,000 adults per week) as were non-infective aLRTD events (median 4.4 [IQR 3.5–5.5] admissions per 100,000 adults per week). While COVID-19 disease was a large component of total aLRTD during this pandemic period, non- SARS-CoV-2 infection still caused the majority of respiratory infection hospitalisations. COVID-19 disease showed significant temporal fluctuations in frequency, which were less apparent in non-SARS-CoV-2 infection. Despite public health interventions to reduce respiratory infection, disease incidence remains high. AvonCAP is an investigator-led project funded under a collaborative agreement by Pfizer. BackgroundThe emergence of COVID-19 and public health measures implemented to reduce SARS-CoV-2 infections have both affected acute lower respiratory tract disease (aLRTD) epidemiology and incidence trends. The severity of COVID-19 and non-SARS-CoV-2 aLRTD during this period have not been compared in detail.MethodsWe conducted a prospective cohort study of adults age ≥18 years admitted to either of two acute care hospitals in Bristol, UK, from August 2020 to November 2021. Patients were included if they presented with signs or symptoms of aLRTD (e.g., cough, pleurisy), or a clinical or radiological aLRTD diagnosis.Findings12,557 adult aLRTD hospitalisations occurred: 10,087 were associated with infection (pneumonia or non-pneumonic lower respiratory tract infection [NP-LRTI]), 2161 with no infective cause, with 306 providing a minimal surveillance dataset. Confirmed SARS-CoV-2 infection accounted for 32% (3178/10,087) of respiratory infections. Annual incidences of overall, COVID-19, and non- SARS-CoV-2 pneumonia were 714.1, 264.2, and 449.9, and NP-LRTI were 346.2, 43.8, and 302.4 per 100,000 adults, respectively. Weekly incidence trends in COVID-19 aLRTD showed large surges (median 6.5 [IQR 0.7-10.2] admissions per 100,000 adults per week), while other infective aLRTD events were more stable (median 14.3 [IQR 12.8-16.4] admissions per 100,000 adults per week) as were non-infective aLRTD events (median 4.4 [IQR 3.5-5.5] admissions per 100,000 adults per week).InterpretationWhile COVID-19 disease was a large component of total aLRTD during this pandemic period, non- SARS-CoV-2 infection still caused the majority of respiratory infection hospitalisations. COVID-19 disease showed significant temporal fluctuations in frequency, which were less apparent in non-SARS-CoV-2 infection. Despite public health interventions to reduce respiratory infection, disease incidence remains high.FundingAvonCAP is an investigator-led project funded under a collaborative agreement by Pfizer. |
ArticleNumber | 100473 |
Author | Adegbite, David Manning, Nicola Brzezinska, Julia Mona, Taslima Szasz-Benczur, Zsuzsa Maskell, Nick A. Fox, Kazminder Finn, Adam Walters, Rhian Suppiah, Seevakumar Turner, Anabella Ward, Lana Begier, Elizabeth Morrison, Leigh Vyse, Andrew Perkins, Fiona Hyams, Catherine Helliker, Kate Challen, Robert Grimwood, Lucy Riaz, Tawassal Osborne, Bethany Maseko, Zandile Southern, Jo McLaughlin, John M. Gonzalez, Maria Garcia Smart, Lily Arachchge, Sandi Nammuni Langdon, Amelia Lazarus, Rajeka Morley, Anna Mattocks, Anya Sequenza, Peter Antico, Rupert Campling, James Ellsbury, Gillian Danon, Leon Grace, Niall Fleming, Leah Scott, Emma Grimes, Charli Kinney, Jane Vasquez, Marianne Marlow, Robin Heath, Robyn Wright, Louise Hubler, Robin Bayley, Francesca Mackay, Vicki Cloake, Julie Taylor, Zoe Oliver, Jennifer Valluri, Srinivas Ruffino, Gabriella Griffiths, Oliver Tilzey, Grace Maughan, Katie Wright, Johanna Kellett Valentine, Gabriella Minou, Konstantina Bellavia, Maddalena Clout, Madeleine Gray, Sharon Bridgeman, Emma Chang, Natalie Milutinovic, Katarina King |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35965672$$D View this record in MEDLINE/PubMed |
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ContentType | Journal Article |
Contributor | Adegbite, David Manning, Nicola Brzezinska, Julia Mona, Taslima Fox, Kazminder Walters, Rhian Suppiah, Seevakumar Turner, Anabella Ward, Lana Morrison, Leigh Perkins, Fiona Helliker, Kate Grimwood, Lucy Riaz, Tawassal Osborne, Bethany Maseko, Zandile Smart, Lily Arachchge, Sandi Nammuni Langdon, Amelia Lazarus, Rajeka Mattocks, Anya Sequenza, Peter Antico, Rupert Grace, Niall Fleming, Leah Scott, Emma Grimes, Charli Vasquez, Marianne Marlow, Robin Heath, Robyn Wright, Louise Bayley, Francesca Mackay, Vicki Cloake, Julie Taylor, Zoe Ruffino, Gabriella Griffiths, Oliver Tilzey, Grace Maughan, Katie Wright, Johanna Kellett Valentine, Gabriella Minou, Konstantina Bellavia, Maddalena Clout, Madeleine Bridgeman, Emma Chang, Natalie Milutinovic, Katarina Friedrich, Zsolt Mitchell, Claire Jeenes-Flanagan, Milo Croxford, Pip |
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Copyright | 2022 The Authors 2022 Published by Elsevier Ltd. 2022 The Authors. Published by Elsevier Ltd. 2022 |
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Keywords | COVID-19 NP-LRTI Pneumonia SARS-CoV-2 CAP Cardiac failure aLRTD HF Lower respiratory tract infection COPD CRDE NP-LRTI, non-pneumonic lower respiratory tract infection COPD, chronic obstructive pulmonary disease HF, heart failure aLRTD, acute lower respiratory tract disease CAP, community acquired pneumonia COVID-19, Coronavirus disease 2019 CRDE, chronic respiratory disease exacerbation |
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SubjectTerms | Cardiac failure COVID-19 Lower respiratory tract infection Pneumonia SARS-CoV-2 |
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