Adults with Severe Acute Respiratory Illness in Glasgow, 2021-22: A Prospective Cohort Study

Objectives

We report the findings of a novel enhanced syndromic surveillance which characterised influenza- and SARS-CoV-2-associated severe acute respiratory illness (SARI) in the 2021/2022 winter season.

Methods

Prospective cohort study of adults admitted to the Queen Elizabeth University Hospital, Glasgow, with a severe acute respiratory illness. Patient demographics, clinical history, admission details, and outcome were recorded.

Results

Between November 2021 and May 2022, 1,063 hospitalised SARI episodes in 1,037 adult patients were identified. Median age was 72.0 years and 44.5% were male. Most (82.6%) SARI cases had ≥1 co-morbidity; chronic lung disease (50.0%) and malignancy (22.5%) were the most frequently reported.

Overall, 229 (22%) and 33 (3%) SARI episodes were SARS-CoV-2 and influenza A PCR positive, respectively. Overall, 74.7%, 6.5% and 43.0% SARI episodes received antibiotics, antivirals, and steroids, respectively (54.5, 11.0 and 51.3% among COVID-19 patients). 1.1% required mechanical ventilation and 7.8% died. Male sex, multimorbidity, frailty, respiratory rate >30, low GCS and chest X-ray consolidation were predictive of in-hospital mortality.

Conclusion

Our syndromic surveillance provided near real-time data on hospitalised SARI to clinicians and Public Health Scotland, and informed them of the evolving clinical epidemiology of SARS-CoV-2 and influenza as we transition from the pandemic phase.