Trends in invasive bacterial diseases during the first 2 years of the COVID-19 pandemic: analyses of prospective surveillance data from 30 countries and territories in the IRIS Consortium

Shaw, D. et al. (2023) Trends in invasive bacterial diseases during the first 2 years of the COVID-19 pandemic: analyses of prospective surveillance data from 30 countries and territories in the IRIS Consortium. Lancet Digital Health, 5(9), e582-e593. (doi: 10.1016/S2589-7500(23)00108-5) (PMID:37516557)

Abstract

Background: The Invasive Respiratory Infection Surveillance (IRIS) Consortium was established to assess the impact of the COVID-19 pandemic on invasive diseases caused by Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus agalactiae. We aimed to analyse the incidence and distribution of these diseases during the first 2 years of the COVID-19 pandemic compared to the 2 years preceding the pandemic. Methods: For this prospective analysis, laboratories in 30 countries and territories representing five continents submitted surveillance data from Jan 1, 2018, to Jan 2, 2022, to private projects within databases in PubMLST. The impact of COVID-19 containment measures on the overall number of cases was analysed, and changes in disease distributions by patient age and serotype or group were examined. Interrupted time-series analyses were done to quantify the impact of pandemic response measures and their relaxation on disease rates, and autoregressive integrated moving average models were used to estimate effect sizes and forecast counterfactual trends by hemisphere. Findings: Overall, 116 841 cases were analysed: 76 481 in 2018–19, before the pandemic, and 40 360 in 2020–21, during the pandemic. During the pandemic there was a significant reduction in the risk of disease caused by S pneumoniae (risk ratio 0·47; 95% CI 0·40–0·55), H influenzae (0·51; 0·40–0·66) and N meningitidis (0·26; 0·21–0·31), while no significant changes were observed for S agalactiae (1·02; 0·75–1·40), which is not transmitted via the respiratory route. No major changes in the distribution of cases were observed when stratified by patient age or serotype or group. An estimated 36 289 (95% prediction interval 17 145–55 434) cases of invasive bacterial disease were averted during the first 2 years of the pandemic among IRIS-participating countries and territories. Interpretation: COVID-19 containment measures were associated with a sustained decrease in the incidence of invasive disease caused by S pneumoniae, H influenzae, and N meningitidis during the first 2 years of the pandemic, but cases began to increase in some countries towards the end of 2021 as pandemic restrictions were lifted. These IRIS data provide a better understanding of microbial transmission, will inform vaccine development and implementation, and can contribute to health-care service planning and provision of policies. Funding: Wellcome Trust, NIHR Oxford Biomedical Research Centre, Spanish Ministry of Science and Innovation, Korea Disease Control and Prevention Agency, Torsten Söderberg Foundation, Stockholm County Council, Swedish Research Council, German Federal Ministry of Health, Robert Koch Institute, Pfizer, Merck, and the Greek National Public Health Organization.

• Item Type: Articles
• Additional Information: The infrastructure for the IRIS Consortium is funded by a Wellcome Trust Investigator Award to ABB (grant number 206394/Z/17/Z). The IRIS databases are part of PubMLST, which is funded by a Wellcome Trust Biomedical Resource Grant awarded to MJCM, ABB, and KAJ (grant number 218205/Z/19/Z). The high-performance computing requirements of the data analyses were supported by the Wellcome Trust Core Award (grant number 203141/Z/16/Z) and the NIHR Oxford Biomedical Research Centre. This work was also partially supported by research funding from the Spanish Ministry of Science and Innovation (grant PID2020-119298RB-I00 to JY); research grants from Pfizer (grant 69765907) to Seoul National University Hospital, and from the Korea Disease Control and Prevention Agency (grant 2018F240600) to Seoul National University College of Medicine; research funding from the Torsten Söderberg Foundation, Stockholm County Council, and the Swedish Research Council to the Karolinska Institutet, Sweden; research funding from the German Federal Ministry of Health and the Robert Koch Institute (grant 1369-237) to the National Reference Centre for Meningococci and Haemophilus influenzae; research funding from the Robert Koch Institute, Pfizer, and Merck, to the German National Reference Centre for Streptococci; and research funding from the Greek National Public Health Organization (EODY) to the Greek National Meningitis Reference laboratory.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Smith, Professor Andrew
• Authors: Shaw, D., Abad, R., Amin-Chowdhury, Z., Bautista, A., Bennett, D., Broughton, K., Cao, B., Casanova, C., Choi, E. H., Chu, Y.-W., Claus, H., Coelho, J., Corcoran, M., Cottrell, S., Cunney, R., Cuypers, L., Dalby, T., Davies, H., de Gouveia, L., Deghmane, A.-E., Demczuk, W., Desmet, S., Domenech, M., Drew, R., du Plessis, M., Duarte, C., Erlendsdóttir, H., Fry, N., Fuursted, K., Hale, T., Henares, D., Henriques-Normark, B., Hilty, M., Hoffmann, S., Humphreys, H., Ip, M., Jacobsson, S., Johnson, C., Johnston, J., Jolley, K. A., Kawabata, A., Kozakova, J., Kristinsson, K. G., Krizova, P., Kuch, A., Ladhani, S., Lâm, T.-T., María Eugenia, L., Lindholm, L., Litt, D., Maiden, M. C.J., Martin, I., Martiny, D., Mattheus, W., McCarthy, N. D., McElligott, M., Meehan, M., Meiring, S., Mölling, P., Morfeldt, E., Morgan, J., Mulhall, R., Muñoz-Almagro, C., Murdoch, D., Murphy, J., Musilek, M., Mzabi, A., Novakova, L., Oftadeh, S., Perez-Arguello, A., Pérez-Vázquez, M., Perrin, M., Perry, M., Prevost, B., Roberts, M., Rokney, A., Ron, M., Sanabria, O. M., Scott, K. J., Sheppard, C., Siira, L., Sintchenko, V., Skoczyńska, A., Sloan, M., Slotved, H.-C., Smith, A. J., Steens, A., Taha, M.-K., Toropainen, M., Tzanakaki, G., Vainio, A., van der Linden, M. P.G., van Sorge, N. M., Varon, E., Vohrnova, S., Gottberg, A. v., Yuste, J., Zanella, R., Zhou, F., and Brueggemann, A. B.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: Lancet Digital Health
• Publisher: Elsevier
• ISSN: 2589-7500
• ISSN (Online): 2589-7500
• Published Online: 27 July 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Lancet Digital Health 5(9):e582-e593
• Publisher Policy: Reproduced under a Creative Commons License

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