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Severity Scale of influenza and acute respiratory illness hospitalizations to support viral genomic surveillance: A Global Influenza Hospital Surveillance Network pilot study
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  • Bronke Boudewijns,
  • Saverio Caini,
  • Marco Del Riccio,
  • Marta Nunes C,
  • Sandra Dos Santos Chaves,
  • Melissa Andrew,
  • Justin Ortiz,
  • Oana Sandulescu,
  • Joseph Bresee,
  • Elena Burtseva,
  • Daouda Coulibaly,
  • Daria Danilenko,
  • Kirill Stolyarov,
  • Anca C. Drăgănescu,
  • Mine Durusu Tanriover,
  • Heloisa Giamberardino,
  • Parvaiz Koul,
  • F. Xavier Lopez-Labrador,
  • Shelly McNeil,
  • Ainara Mira-Iglesias,
  • Alejandro Orrico,
  • Nancy A. Otieno,
  • Jorim Ayugi,
  • Sonia Raboni,
  • Peter Spreeuwenberg
Bronke Boudewijns
Nederlands Instituut voor Onderzoek van de Gezondheidszorg

Corresponding Author:[email protected]

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Saverio Caini
Nederlands Instituut voor Onderzoek van de Gezondheidszorg
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Marco Del Riccio
Nederlands Instituut voor Onderzoek van de Gezondheidszorg
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Marta Nunes C
Hospices Civils de Lyon
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Sandra Dos Santos Chaves
Fondation de France
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Melissa Andrew
Dalhousie University Department of Medicine
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Justin Ortiz
University of Maryland Center for Vaccine Development
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Oana Sandulescu
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti Biblioteca Carol Davila
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Joseph Bresee
The Task Force for Global Health
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Elena Burtseva
Gamaleya Federal Research Center for Epidemiology and Microbiology Ministry of Health of Russian Federation
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Daouda Coulibaly
Institut National d'Hygiene Publique
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Daria Danilenko
Smorodintsev Research Institute of Influenza
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Kirill Stolyarov
Smorodintsev Research Institute of Influenza
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Anca C. Drăgănescu
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti Biblioteca Carol Davila
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Mine Durusu Tanriover
Hacettepe Universitesi
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Heloisa Giamberardino
Hospital Pequeno Principe
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Parvaiz Koul
Sher-i-Kashmir Institute of Medical Sciences
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F. Xavier Lopez-Labrador
Fundacio per al Foment de la Investigacio Sanitaria i Biomedica
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Shelly McNeil
Dalhousie University Department of Medicine
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Ainara Mira-Iglesias
Fundacio per al Foment de la Investigacio Sanitaria i Biomedica
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Alejandro Orrico
Fundacio per al Foment de la Investigacio Sanitaria i Biomedica
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Nancy A. Otieno
Kenya Medical Research Institute
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Jorim Ayugi
Kenya Medical Research Institute
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Sonia Raboni
Universidade Federal do Parana
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Peter Spreeuwenberg
Nederlands Instituut voor Onderzoek van de Gezondheidszorg
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Abstract

Background: This study aimed to establish a Severity Scale for influenza and other acute respiratory infections (ARI), requiring hospitalization, for surveillance and research purposes (the SevScale). Such a scale could aid the interpretation of data gathered from disparate settings. This could facilitate pooled analyses linking viral genetic sequencing data to clinical severity, bringing insights to inform influenza surveillance and the vaccine strain selection process. Methods: We used a subset of data from the Global Influenza Hospital Surveillance Network database, including data from different geographical areas and income levels. To quantify the underlying concept of severity, an item response model was developed using sixteen indicators of severity related to the hospital stay. Each patient in the dataset was assigned a Severity Score and a Severity Category (low, medium, or high severity). Finally, we compared the model scores across different subgroups. Results: Data from 9 countries were included, covering between 4 and 11 seasons from 2012 to 2022, with a total of 96,190 ARI hospitalizations. Not for all severity indicators data was available for all included seasons. Subgroups with a high percentage of patients in the High Severity Category included influenza A(H1N1)pdm09, age ≥50, lower-middle income countries, and admission since the start of the COVID-19 pandemic. Conclusions: The initial model successfully highlighted severity disparities across patient subgroups. Repeating this exercise with new, more complete data would allow recalibration and validation of the current model. The SevScale proved to be a promising method to define severity for influenza vaccine strain selection, surveillance and research.
29 Aug 2024Submitted to Influenza and other respiratory viruses
25 Sep 2024Submission Checks Completed
25 Sep 2024Assigned to Editor
08 Oct 2024Reviewer(s) Assigned