Epidemiology and burden of Severe Acute Respiratory Infections (SARI) in the aftermath of COVID-19 pandemic: A prospective sentinel surveillance study in a Tunisian Medical ICU, 2022/2023.

Autor:	Boussarsar M; University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia.; Medical Intensive Care Unit, Research Laboratory 'Heart Failure', Farhat Hached University Hospital, Sousse, Tunisia., Ennouri E; University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia.; Medical Intensive Care Unit, Research Laboratory 'Heart Failure', Farhat Hached University Hospital, Sousse, Tunisia., Habbachi N; University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia., Bouguezzi N; University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia.; Medical Intensive Care Unit, Research Laboratory 'Heart Failure', Farhat Hached University Hospital, Sousse, Tunisia., Meddeb K; University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia.; Medical Intensive Care Unit, Research Laboratory 'Heart Failure', Farhat Hached University Hospital, Sousse, Tunisia., Gallas S; University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia.; Medical Intensive Care Unit, Research Laboratory 'Heart Failure', Farhat Hached University Hospital, Sousse, Tunisia., Hafdhi M; University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia., Zghidi M; University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia.; Medical Intensive Care Unit, Research Laboratory 'Heart Failure', Farhat Hached University Hospital, Sousse, Tunisia., Toumi R; University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia.; Medical Intensive Care Unit, Research Laboratory 'Heart Failure', Farhat Hached University Hospital, Sousse, Tunisia., Ben Saida I; University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia.; Medical Intensive Care Unit, Research Laboratory 'Heart Failure', Farhat Hached University Hospital, Sousse, Tunisia., Abid S; National Influenza Centre-Tunis, Unit Virology, Microbiology Laboratory, Charles Nicolle Hospital, Tunis, Tunisia.; University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia., Boutiba-Ben Boubaker I; National Influenza Centre-Tunis, Unit Virology, Microbiology Laboratory, Charles Nicolle Hospital, Tunis, Tunisia.; University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia., Maazaoui L; Primary Health Care Directorate, Tunis, Tunisia., El Ghord H; Primary Health Care Directorate, Tunis, Tunisia., Gzara A; Primary Health Care Directorate, Tunis, Tunisia., Yazidi R; Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, Tunis-Belvédère, Tunisia.; Service of Medical Epidemiology, Institut Pasteur de Tunis, Tunis-Belvédère, Tunisia.; Laboratory of Transmission, Control and Immunobiology of Infections LR16IPT02, Institut Pasteur de Tunis, University of Tunis, El Manar, Tunis, Tunisia., Ben Salah A; Service of Medical Epidemiology, Institut Pasteur de Tunis, Tunis-Belvédère, Tunisia.; Department of Family and Community Medicine, College of Medicine and Medical Sciences (CMMS), Arabian Gulf University (AGU), Manama, Bahrain.
Jazyk:	angličtina
Zdroj:	PloS one [PLoS One] 2023 Dec 15; Vol. 18 (12), pp. e0294960. Date of Electronic Publication: 2023 Dec 15 (Print Publication: 2023).
DOI:	10.1371/journal.pone.0294960
Abstrakt:	Background: Severe Acute Respiratory Infections (SARI) caused by influenza and other respiratory viruses pose significant global health challenges, and the COVID-19 pandemic has further strained healthcare systems. As the focus shifts from the pandemic to other respiratory infections, assessing the epidemiology and burden of SARI is crucial for healthcare planning and resource allocation. Aim: to understand the impact of the post-pandemic period on the epidemiology of SARI cases, clinical outcomes, and healthcare resource utilization in Tunisia. Methods: This is a prospective study conducted in a Tunisian MICU part of a national sentinel surveillance system, focusing on enhanced SARI surveillance. SARI cases from week 39/2022, 26 September to week 19/2023, 13 May were included, according to a standardized case definition. Samples were collected for virological RT-PCR testing, and an electronic system ensured standardized and accurate data collection. Descriptive statistics were performed to assess epidemiology, trends, and outcomes of SARI cases, and univariate/multivariate analyses to assess factors associated with mortality. Results: Among 312 MICU patients, 164 SARI cases were identified during the study period. 64(39%) RT-PCR were returned positive for at least one pathogen, with influenza A and B strains accounting for 20.7% of cases at the early stages of the influenza season. The MICU experienced a significant peak in admissions during weeks 1-11/2023, leading to resource mobilization and the creation of a surge unit. SARI cases utilized 1664/3120 of the MICU-stay days and required 1157 mechanical ventilation days. The overall mortality rate among SARI cases was 22.6%. Age, non-COPD, and ARDS were identified as independent predictors of mortality. Conclusions: The present study identified a relatively high rate of SARI cases, with 39% positivity for at least one respiratory virus, with influenza A and B strains occurring predominantly during the early stages of the influenza season. The findings shed light on the considerable resource utilization and mortality associated with these infections, underscoring the urgency for proactive management and efficient resource allocation strategies. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2023 Boussarsar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu Plný text ve formátu PDF