Factors associated with Severe Acute Respiratory Syndrome in a Brazilian central region

Abstract Severe Acute Respiratory Infection (SARI) is a notifiable syndrome that must be investigated. This study aimed to analyze the epidemiological profile and factors associated with SARI-related hospitalization and deaths reported in Goiás. Retrospective cohort study, with data from the investigation files of the Notifiable Diseases Information System’s Influenza Web. Multivariate analysis methods were employed to verify the association between exposure variables with the outcomes of ICU admission and death. A total of 4,832 SARI cases were reported in Goiás from 2013 to 2018. The primary etiological diagnosis was Influenza A (22.3%) with the predominant subtype A (H1N1pdm09), followed by the Respiratory Syncytial Virus. A total of 34.6% of the patients required ICU admission, and 19% died. A longer time to start treatment with antivirals was associated with a higher likelihood to have an ICU admission, while a previous non-vaccination against Influenza, longer time to start treatment, and older age were associated with a higher likelihood to suffer death. The study showed a high frequency of respiratory diseases caused by the Influenza virus in Goiás and that the severity of the syndrome, characterized by ICU admission and deaths, is associated with the start of antiviral treatment vaccine status, and patient’s age.

摘要 严重急性呼吸道感染（Severe Acute Respiratory Infection，SARI）是一种需开展流行病学调查的法定报告综合征。本研究旨在分析戈亚斯州（Goiás）报告的与SARI相关的住院及死亡病例的流行病学特征与关联因素。本研究为回顾性队列研究，数据来源于法定传染病信息系统流感监测网络（Notifiable Diseases Information System’s Influenza Web）的调查档案。研究采用多变量分析方法，探究各类暴露因素与ICU入住、死亡这两类结局指标之间的关联。
2013年至2018年期间，戈亚斯州累计报告SARI病例4832例。首要病原学诊断为甲型流感（占比22.3%），优势亚型为A（H1N1pdm09），其次为呼吸道合胞病毒（Respiratory Syncytial Virus）。总计34.6%的患者需入住重症监护病房（Intensive Care Unit，ICU），19%的患者最终死亡。
抗病毒治疗启动延迟与ICU入住风险升高显著相关；而既往未接种流感疫苗、抗病毒治疗启动延迟以及年龄偏大，则与死亡风险升高显著相关。
本研究结果显示，戈亚斯州流感病毒引发的呼吸道疾病占比颇高，且以ICU入住、死亡为特征的综合征严重程度，与抗病毒治疗启动时机、疫苗接种状态以及患者年龄密切相关。