An increase in the number of non-COVID-19 respiratory infections should be expected this winter, say scientists. The warning comes following the results of a new study, published in The Lancet Regional Health – Europe, which found that over 55% of respiratory disease hospitalisations during the pandemic’s peak were caused by non-SARS-CoV-2 infections.
The University Bristol-led study funded and conducted in collaboration with Pfizer Inc., as part of AvonCAP, is the first to compare the number of hospitalisations from respiratory disease infections caused by COVID-19 and non-SARS-CoV-2 infections.
Using data from 135,014 hospitalisations from two large hospitals in Bristol between August 2020 and November 2021, researchers identified 12,557 admissions attributable to acute Lower Respiratory Tract Disease (aLRTD) with patients admitted with signs or symptoms of respiratory infections including cough, fever, pleurisy, or a clinical or radiological aLRTD diagnosis. Of these, 12,248 (98%) patients, comprising mainly older adults, consented to participate in the study.
Following further analysis, the team show that of the 12,248 aLRTD hospitalisations, 55% (6,909) were due to infection with no evidence of SARS-CoV-2, while confirmed SARS-CoV-2 infection only accounted for 26% (3,178) of respiratory infections. The remaining 17% (2,161) were due to infection with no infective cause.
Adam Finn, Professor of Paediatrics at the University of Bristol, Director of the Bristol Vaccine Center at Bristol Medical School and lead of Bristol UNCOVER (Bristol COVID Emergency Research Group), said: “What is really surprising from our results is just how much other non-COVID respiratory infections there was during this time, other infections clearly didn’t just disappear and despite significant public health measures, including both vaccination and non-pharmaceutical intervention such as masks, our findings show there was still a high incidence of non- COVID-19 disease causing hospitalisations alongside COVID-19 patients. “
Dr Catherine Hyams, Post-Doctoral Clinical Research Fellow, Principal Investigator for the AvonCAP study and one of the study’s lead authors at the University of Bristol, added: “Our results really highlight not only the huge burden of respiratory infection on the NHS and other healthcare systems, but also how bad things may get this winter. It is therefore essential that appropriate healthcare planning and resource allocation is undertaken to care for patients with respiratory conditions, in addition to implementation of public health measures to reduce respiratory disease burden and improve patient outcomes. “
The study is part of AvonCAP, an ongoing collaborative surveillance project funded by Pfizer Inc., which records detailed information on every adult patient admitted to Bristol’s two large NHS hospitals with symptoms, signs and / or X-ray evidence of acute disease in the lungs .
‘Incidence of community acquired lower respiratory tract disease in Bristol, UK during the COVID-19 pandemic: a prospective cohort study’ by A Finn et al. in The Lancet Regional Health – Europe
COVID-19 research outputs
A full list of University of Bristol research outputs relating to the COVID-19 pandemic is available online.
Bristol UNCOVER Group
In response to the COVID-19 crisis, researchers at the University of Bristol formed the Bristol COVID Emergency Research Group (UNCOVER) to pool resources, capacities and research efforts to combat this infection.
Bristol UNCOVER includes clinicians, immunologists, virologists, synthetic biologists, aerosol scientists, epidemiologists and mathematical modellers and has links to behavioural and social scientists, ethicists and lawyers.
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For more information about the University of Bristol’s coronavirus (COVID-19) research priorities visit: http://www.bristol.ac.uk/research/impact/coronavirus/research-priorities/
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About the AvonCAP study
The AvonCAP (community-acquired pneumonia) study from Bristol is a prospective test negative case control study of adult respiratory infection and vaccine-preventable pneumococcal disease in the context of COVID-19 admitted to two large NHS hospitals. The study is conducted in collaboration with and funded by Pfizer Inc. The study funder had no role in data collection, but collaborated in study design, data interpretation and analysis, and writing this manuscript.