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Original Research
Comparing adults with severe SARS-CoV-2 or influenza infection: South Africa, 2016–2021
Submitted: 14 September 2023 | Published: 26 July 2024
About the author(s)
Fiona Els, Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; and, South African Field Epidemiology Training Programme (SAFETP), Division of Public Health, Surveillance and Response (DPHSR), National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; and, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South AfricaJackie Kleynhans, Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; and, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Nicole Wolter, Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; and, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Mignon du Plessis, Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; and, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Fahima Moosa, Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; and, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Stefano Tempia, Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; and, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Mvuyo Makhasi, Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa
Jeremy Nel, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Halima Dawood, Department of Medicine, Greys Hospital, Pietermaritzburg and Centre for the Aids programme of research in South Africa, University of KwaZulu-Natal, Pietermaritzburg, South Africa
Susan Meiring, Division of Public Health Surveillance and Response, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa
Anne von Gottberg, Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; and, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Cheryl Cohen, Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; and, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Sibongile Walaza, Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD) of the National Health Laboratory Service (NHLS), Johannesburg, South Africa; and, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Abstract
Background: Comparisons of the characteristics of individuals hospitalised with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or seasonal influenza in low-to middle-income countries with high human immunodeficiency virus (HIV) prevalence are limited.
Objectives: Determine the epidemiological differences with those hospitalised with influenza or SARS-CoV-2 infection.
Method: We investigated hospitalised individuals ≥18 years of age testing positive for seasonal influenza (2016–2019) or SARS-CoV-2 (2020–2021). We used random effects multivariable logistic regression, controlling for clustering by site, to evaluate differences among adults hospitalised with influenza or SARS-CoV-2 infection.
Results: Compared to individuals with influenza, individuals with SARS-CoV-2 infection were more likely to be diabetic (adjusted odds ratio [aOR]: 1.70, 95% confidence interval [CI]: 1.11–2.61) or die in hospital (aOR: 2.57, 95% CI: 1.61–4.12). Additionally, those with SARS-CoV-2 infection were less likely to be living with HIV (not immunosuppressed) (aOR: 0.50, 95% CI: 0.34–0.73) or living with HIV (immunosuppressed) (aOR: 0.27, 95% CI: 0.18–0.39) compared to not living with HIV and less likely to be asthmatic (aOR: 0.21, 95% CI: 0.13–0.33) rather than those living with influenza.
Conclusion: Individuals hospitalised with SARS-CoV-2 had different characteristics to individuals hospitalised with influenza before the coronavirus disease 2019 (COVID-19) pandemic. Risk factors should be considered in health management especially as we move into an era of co-circulation of SARS-CoV-2 and influenza pathogens.
Contribution: Identifying groups at high risk of severe disease could help to better monitor, prevent and control SARS-CoV-2 or influenza severe disease.
Keywords
Sustainable Development Goal
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