丹麦成年人与呼吸道合胞病毒、流感和COVID-19相关的高死亡率和住院率（2015-2024年）：一项模型研究

IF 13 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Europe Pub Date : 2025-07-18 DOI:10.1016/j.lanepe.2025.101396

Amanda Marie Egeskov-Cavling , Chelsea L. Hansen , Caroline Klint Johannesen , Birgitte Lindegaard , Samir Bhatt , Cecile Viboud , Thea K. Fischer

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引用次数: 0

摘要

背景了解RSV、流感和COVID-19的长期流行病学趋势对于制定疫苗接种策略和卫生保健系统流行病防范至关重要。这是第一个在欧洲环境中对这些呼吸道病毒导致的成人超额死亡率和住院率进行全面估计的研究。我们的目标是估计2015年1月至2024年3月丹麦≥18岁成年人中RSV、流感和COVID-19的超额死亡率和超额住院率。方法：这项全国性的时间趋势建模研究调查了丹麦成年人RSV、流感和COVID-19每周死亡率和住院率超过季节性基线的情况。使用广义加性模型（GAM）使用负二项似然函数分析来自死亡原因登记册、丹麦国家患者登记册和呼吸道病毒监测数据的数据，包括RSV、流感、COVID-19变体和时间效应，以解释季节性和趋势。我们估计有3944人死于rsv， 5675人死于流感，5636人死于covid -19。在65岁及以上的成年人中，RSV的年死亡率为31.2 / 10万，流感为42.9 / 10万，COVID-19为88.5 / 10万。此外，我们估计65岁及以上患者的年入院率为每10万人中有177.4人感染RSV，每10万人中有164.6人感染流感，每10万人中有398.7人感染COVID-19。这项建模研究揭示了呼吸道合胞病毒对65岁及以上人群的重大影响，近年来呼吸道合胞病毒导致的死亡和住院人数显著增加，这可能是由于COVID-19大流行后呼吸道检测的扩大。我们的研究结果强调需要提高以前认为低风险患者的认识，并为评估预防性干预措施建立基准。本研究由丹麦独立研究基金资助。

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Excess mortality and hospitalisations associated with respiratory syncytial virus, influenza, and COVID-19 among adults in Denmark (2015–2024): a modelling study

Background

Understanding the long-term epidemiology trends of RSV, influenza, and COVID-19 is essential for planning of vaccination strategies and healthcare system epidemic preparedness. This is the first study to provide a comprehensive estimation of both excess mortality and hospitalisations among adults for these respiratory viruses in a European setting. We aim to estimate excess mortality and excess hospitalisations for RSV, influenza, and COVID-19 among adults ≥18 years in Denmark from January 2015 to March 2024.

Methods

This nationwide time-trend modelling study investigates weekly mortality and hospitalisation rates surpassing the seasonal baseline for RSV, influenza, and COVID-19 among adults in Denmark. Data from the Cause of Death Register, the Danish National Patient Registry, and respiratory virus surveillance data were analysed with Generalized Additive Models (GAM) using a negative binomial likelihood function, including RSV, influenza, COVID-19 variants, and time effects to account for seasonality and trend.

Findings

We estimated 3944 RSV-attributed, 5675 influenza-attributed, and 5636 COVID-19-attributed deaths. Among adults aged 65 or older, the annual mortality rates were 31.2 per 100,000 for RSV, 42.9 for influenza, and 88.5 for COVID-19. Furthermore, we estimated annual admission rates for those aged 65 and older of 177.4 per 100,000 for RSV, 164.6 for influenza, and 398.7 for COVID-19.

Interpretation

This modelling study reveals a substantial impact of RSV on individuals aged 65 and older, with a notable increase in RSV-attributed deaths and hospitalisations in recent years likely due to expanded respiratory testing after the COVID-19 pandemic. Our findings highlight the need for increased awareness in previously considered lower-risk patients, and establish benchmarks for evaluating preventive interventions.

Funding

This study received funding from Independent Research Fund Denmark.

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来源期刊

Lancet Regional Health-Europe Multiple-

CiteScore

19.90

自引率

1.40%

发文量

260

审稿时长

9 weeks

期刊介绍： The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.