TY - JOUR
T1 - Comparison of the Incidence and Risk Factors of Acute Respiratory Illness Associated With COVID-19 and Influenza
T2 - Results of the SHIVERS II, III, and IV Prospective Community Cohort Study
AU - Huang, Q. Sue
AU - Wood, Tim
AU - Aminisani, Nayyereh
AU - Kvalsvig, Amanda
AU - Baker, Michael G.
AU - Nghiem, Nhung
AU - Seeds, Ruth
AU - Jennings, Tineke
AU - Jelley, Lauren
AU - Tan, Chor Ee
AU - O'Neill, Meaghan
AU - Utekar, Srushti
AU - Geoghegan, Jemma L.
AU - Winter, David
AU - Turner, Nikki
AU - Dowell, Tony
AU - Balm, Michelle
AU - Grant, Cameron C.
AU - Nesdale, Annette
AU - Dobinson, Hazel C.
AU - Daniells, Karen
AU - Mcintyre, Peter
AU - Widdowson, Marc-Alain
AU - Thomas, Paul G.
AU - Webby, Richard J.
AU - Team, SHIVERS Investigation
PY - 2025/3/18
Y1 - 2025/3/18
N2 - Background. While severe outcomes among hospitalized patients with COVID-19 and influenza are well described, comparative studies are lacking on community transmission and milder illnesses associated with COVID-19 and influenza. Methods. This study is based on a prospective community cohort in Wellington, New Zealand, consisting of participants with acute respiratory illness associated with COVID-19 and influenza, as confirmed by polymerase chain reaction. From 7 February to 2 October 2022, we compared the incidence, risk/protective factors, and clinical features among them. Results. The crude incidence of COVID-19-associated acute respiratory illness was 59 per 100 person-years (PY). The adjusted cumulative incidence for COVID-19 (77/100 PY; 95% CI, 75-80) was 4.5 times higher than for influenza (17/100 PY; 95% CI, 15-19). Among all COVID-19 cases, the proportion of children aged 0 to 17 years with COVID-19 was substantial but smaller than those of influenza (402/1229 [33%] vs 173/255 [68%], P < .0001). The highest incidence of COVID-19 was among adolescents aged 12 to 17 years (109/100 PY; 95% CI, 97-119) and individuals who were European and other ethnicity (83/100 PY; 95% CI, 80-86), whereas the highest influenza incidence was among children aged 1 to 4 years (49/100 PY; 95% CI, 40-58) and M & amacr;ori (35/100 PY; 95% CI, 28-43). Adolescents aged 12 to 17 years had 2.5-times higher peak COVID-19 incidence (5.9/100) than adults aged >= 18 years (2.4/100). Adolescents with 2 doses of the COVID-19 vaccines had 75% greater risk of COVID-19 infection (hazard ratio, 1.75; 95% CI, 1.40-2.20) as compared with adults with 3 doses. Vaccination, age, ethnicity, and household size were independent protective/risk factors for COVID-19 or influenza. Participants with COVID-19, as compared with influenza, were less likely to access health care or experience febrile and severe illnesses but more likely to report sore throat, headache, myalgia, and taste or smell loss. Conclusions. As the world transitions to COVID-19 endemicity, estimating disease burdens in community settings becomes important to understand complete disease pyramids, risk factors, and clinical progression for informing countermeasures.
AB - Background. While severe outcomes among hospitalized patients with COVID-19 and influenza are well described, comparative studies are lacking on community transmission and milder illnesses associated with COVID-19 and influenza. Methods. This study is based on a prospective community cohort in Wellington, New Zealand, consisting of participants with acute respiratory illness associated with COVID-19 and influenza, as confirmed by polymerase chain reaction. From 7 February to 2 October 2022, we compared the incidence, risk/protective factors, and clinical features among them. Results. The crude incidence of COVID-19-associated acute respiratory illness was 59 per 100 person-years (PY). The adjusted cumulative incidence for COVID-19 (77/100 PY; 95% CI, 75-80) was 4.5 times higher than for influenza (17/100 PY; 95% CI, 15-19). Among all COVID-19 cases, the proportion of children aged 0 to 17 years with COVID-19 was substantial but smaller than those of influenza (402/1229 [33%] vs 173/255 [68%], P < .0001). The highest incidence of COVID-19 was among adolescents aged 12 to 17 years (109/100 PY; 95% CI, 97-119) and individuals who were European and other ethnicity (83/100 PY; 95% CI, 80-86), whereas the highest influenza incidence was among children aged 1 to 4 years (49/100 PY; 95% CI, 40-58) and M & amacr;ori (35/100 PY; 95% CI, 28-43). Adolescents aged 12 to 17 years had 2.5-times higher peak COVID-19 incidence (5.9/100) than adults aged >= 18 years (2.4/100). Adolescents with 2 doses of the COVID-19 vaccines had 75% greater risk of COVID-19 infection (hazard ratio, 1.75; 95% CI, 1.40-2.20) as compared with adults with 3 doses. Vaccination, age, ethnicity, and household size were independent protective/risk factors for COVID-19 or influenza. Participants with COVID-19, as compared with influenza, were less likely to access health care or experience febrile and severe illnesses but more likely to report sore throat, headache, myalgia, and taste or smell loss. Conclusions. As the world transitions to COVID-19 endemicity, estimating disease burdens in community settings becomes important to understand complete disease pyramids, risk factors, and clinical progression for informing countermeasures.
KW - COVID-19 or SARS-CoV-2
KW - Acute respiratory illnesses
KW - Influenza
KW - Prospective community cohort
KW - Risk factor
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=anu_research_portal_plus2&SrcAuth=WosAPI&KeyUT=WOS:001447093700001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1093/infdis/jiaf097
DO - 10.1093/infdis/jiaf097
M3 - Article
C2 - 39993961
SN - 0022-1899
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
ER -