Surveillance of influenza B severe hospitalized cases during 10 seasons in Catalonia : Does the lineage make a difference?
Soldevila, Núria (Universitat de Barcelona)
Basile, Luca (Servei Català de la Salut)
Martínez, Ana (Instituto de Salud Carlos III)
Torner, Núria (Instituto de Salud Carlos III)
Marcos, M. Ángeles (Hospital Clínic i Provincial de Barcelona)
Mosquera, Maria del Mar (Hospital Clínic i Provincial de Barcelona)
Antón, Andrés (Hospital Universitari Vall d'Hebron)
Andrés, Cristina (Hospital Universitari Vall d'Hebron)
Rius i Gibert, Maria Cristina (Institut d'Investigació Biomèdica Sant Pau)
Pumarola, Tomàs (Hospital Universitari Vall d'Hebron)
Domínguez, Ángela (Instituto de Salud Carlos III)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	Influenza B viruses circulate in two lineages (B/Victoria and B/Yamagata). Although classically affecting children, recently it has shown a high rate of infection and increased hospitalization in the elderly. To describe and analyze the clinical and epidemiological characteristics of severe hospitalized laboratory-confirmed influenza B virus (SHLCI-B) cases in Catalonia associated with mismatch from Influenza B virus strain included in the trivalent influenza vaccine (TIV). SHLCI-B was registered by the influenza sentinel surveillance system of Catalonia (PIDIRAC) during ten surveillance seasons from 2010 to 2020. Variables age, comorbidities, and vaccination status were recorded. Vaccine effectiveness was estimated as (1-OR) for intensive care unit (ICU) admission. Statistical significance was established at p < 0. 05. A total of 1159 SHLCI-B were registered, of these 68. 2% (791) corresponded to the 2017-2018 season; 21. 8% (253) were admitted to ICU and 13. 8% (160) were exitus; 62. 5% (725) cases occurred in those aged >64 years; most frequent risk factor was cardiovascular disease (35. 1%, 407) followed by chronic pulmonary obstructive disease-COPD (24. 6%, 285) and diabetes (24. 1%, 279). In four seasons, the predominant circulating lineage was B/Victoria, in two seasons the B/Yamagata lineage and four seasons had no IBV activity. Four seasons presented discordance with the strain included within the TIV. Vaccine effectiveness (VE) to prevent ICU admission was 31% (95% confidence interval [CI]: 4%-51%; p = 0. 03); being 29% (95% CI: −3% to 51%) in discordant and 43% (95% CI:−43% to 77%) in concordant seasons. Significant differences were observed in the number of affected aged > 64 years (odds ratio [OR] = 2. 5; 95% CI: 1. 9-3. 4; p < 0. 001) and in patients with heart disease (OR = 2. 40 95% CI: 1. 7-3. 4; p < 0. 001), COPD (OR = 1. 6 95% CI: 1. 1-2. 3; p = 0. 01), and diabetes (OR = 1. 5 95% CI: 1. 1-2. 1; p = 0. 04) between discordant and concordant seasons. The increase in hospitalization rate in people> 64 years of age and those presenting comorbidities in seasons with circulating influenza B virus belonging to a lineage discordant with the strain included in the TIV and the decrease of VE to prevent ICU admissions evidence the vital need to administer the quadrivalent influenza vaccine regardless of the findings of predominant circulation in the previous season.
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Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	Journal of Medical Virology, Vol. 94 Núm. 9 (september 2022) , p. 4417-4424, ISSN 1096-9071

DOI: 10.1002/jmv.27876
PMID: 35593301

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