National Institute of Health Dr. Ricardo Jorge
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Personalized Medicine: towards implementation in healthcare
No full textThe presentation titled "Personalised Medicine: Towards Implementation in Healthcare" explored the integral role of personalized medicine within the broader concept of Person-Centered Care. The fundamental principles guiding this approach include recognizing each individual's uniqueness, addressing their specific needs, ensuring informed consent, and involving them in decisions related to their therapies.
Personalized medicine, as defined in the European Council Conclusion on personalized medicine for patients, involves characterizing individuals' phenotypes and genotypes to tailor therapeutic strategies, evaluate predisposition to diseases, and deliver timely prevention. Over the last few decades, significant advancements in genetics, including the development and application of innovative technologies, have led to a profound understanding of genetic information and molecular mechanisms underlying hereditary diseases.
The impact of advances in genetic diagnostics and testing on healthcare has been substantial, resulting in more efficient and accurate testing methods. The transition from genetics to genomics has particularly influenced healthcare systems globally, giving rise to genomic medicine. The benefits of genomic medicine encompass accurate diagnosis, reduced number of medical appointments, exams and the long "diagnostic odyssey, personalized cancer treatment based on genetic profiles, improved effectiveness and reduced adverse drug reactions through pharmacogenomics, and evaluation of genetic risk profiles for chronic diseases.
Genomic data has also facilitated the matching of patients with appropriate clinical trials, contributing to more equitable treatments for diverse ethnicities. The presentation emphasized that genomics is already enabling precise prediction, diagnosis, and treatment of diseases.
The Declaration of Cooperation, "Towards access to at least 1 million sequenced genomes in the EU by 2022," was highlighted. Signed by the Portuguese Ministry of Health in 2018, the initiative involves 25 EU countries, the UK, and Norway. Its primary goal is to provide secure access to genomic and clinical data across Europe, fostering collaborative investigation of diseases and enhancing the competitiveness of the EU in predictive, preventive, and participatory healthcare.
The strategy to achieve the 1+MG initiative includes obtaining clinical data from patients and general citizens, with the Genome of Europe Project contributing with at least 500,000 genomes. This multi-country project aims to build a collective reference genome cohort representing the genetic composition of the European population.
In 2021, the Portuguese government established the multidisciplinary Commission PT-MedGen to define the roadmap for implementing the Portuguese National Strategy for Genomic Medicine. This strategy aligns with the 1+MG initiative, outlining objectives, stages, activities, goals, deadlines, expected results, and investment needs for the successful implementation of genomic medicine in Portugal.N/
An innovative food product based on melon by-product: mineral profile
No full textThe demand for foods with positive health effects has increased as a result of the notable expansion in interest in health, food, and well-being in Europe and other developed countries. Fruit by-products are a good source of important nutrients like dietary fiber, fat, protein, vitamins, minerals, and other bioactive elements. In recent years, research has been conducted to determine whether these by-products may be used to enrich food products, with the goal of producing foods that are more nutritious and may have positive health effects. The objective of this study was to develop a muffin formulation based on melon peel flour and evaluate its composition regarding macroelements and trace elements (essential and non-essential).
In 2021, melon peels were recovered from melon production and distribution companies, located in Torres Vedras and Rio Maior (Portugal). The melon peels were manually separated, dehydrated (50 ºC, 18h), homogenised, and sieved until a fine powder (melon peel flour) was obtained. A traditional recipe for muffins (control sample) and an innovative muffin, where the wheat flour was replaced by melon peel flour were prepared. The macroelements (Ca, Mg and P) and trace elements were analysed by inductively coupled plasma mass spectrometry and sodium and potassium were analysed by flame atomic absorption spectrometry.
Regarding the results obtained, the main macroelements present in the melon peel flour were potassium (26 ± 0,7 mg/g) and calcium (8 ± 0,1 mg/g) and the most abundant essential trace elements were iron, manganese and zinc. By replacing wheat flour with melon peel flour, the magnesium, calcium and potassium contents increased. The highest increase was observed for potassium content (4 mg/g). Regarding essential trace elements, the incorporation of melon peel flour increased the content of iron, manganese and molybdenum.
The melon peel flour can be considered a good source of macroelements such as potassium, calcium and phosphorus, and essential trace elements such as iron, manganese and zinc. The incorporation of melon peel flour allowed the development of a formulation rich in potassium, phosphorus and magnesium. This by-product has the potential to improve food security, nutrition, and economic well-being on a global scale, as well as the general health and well-being of people, animals, and the environment, supporting the One Health concept.This work was financially supported by Foundation for Science and Technology (FCT) under the projects Food4DIAB (EXPL/BAA-AGR/1382/2021); and UIDB/50006/2020 and by AgriFood XXI I&D&I project (NORTE-01-0145-FEDER-000041) co-financed by European Regional Development Fund (ERDF), through the NORTE 2020 (Programa Operacional Regional do Norte 2014/2020). Rita C. Alves thanks to FCT the CEECIND/01120/2017 contract.info:eu-repo/semantics/publishedVersio
Years of life lost associated with COVID-19 deaths in Portugal: two years of pandemic
Get PDFAbstract publicado em. Eur J Public Health. 2023 Oct; 33(Suppl 2):ckad160.701. https://doi.org/10.1093/eurpub/ckad160.701Background: The impact of the COVID-19 pandemic on the Portuguese population is still underexplored. Therefore, the characteriza tion of years of life lost (YLL) due to this epidemic may provide relevant data for establishing effective strategies in future epidemics. The aim of this study was to calculate YLL associated with COVID-19 deaths in Portugal between 2020 and 2022. Methods: This was an observational, cross-sectional study. Data on the average resident population and life expectancy at birth by age group and sex were obtained from Statistics Portugal (INE) and GBD 2019 standard life-table, respectively. Data on COVID-19 deaths were extracted from the Directorate-General of Health’s (DGS) reports. YLL was calculated as the number of COVID-19 deaths multiplied by standard life expectancy at the age of death, globally, by sex and age group. YLL was calculated by 100,000 population and age-standardized. Results: Between 2020 and 2022, 3413013 cases of COVID-19 were reported in Portugal, of which 21342 (0.6%) eventually died of the disease. The number of deaths by sex was similar globally or by age group. Globally, the YLLs estimated for COVID-19 in Portugal were 309383,8. YLLs were higher for males than for females for most age groups except of age groups 10-19 yrs (76.56 vs 153.11) and > 80 yrs (58710.88 vs 68491.44). YLLs age-standardized also showed a steady increase as we progressed in the age group [from 3.25 (0-9 yrs) to 885.54 (>80 yrs)], in which from the 50-59 yrs age group onwards we observed a steeper slope of increase in YLLs. Conclusions: COVID-19 has had a major impact on mortality rates in Portugal, with this impact being greater in the older population, especially in people aged over 70 years. Also, males presented higher YLLs than females, with this difference increasing substantially as age increases. These insights can be useful in terms of public health as the disease progresses to an endemic phase.Key messages: - COVID-19 has had a major impact on mortality rates in Portugal; - Calculating YLLs associated with COVID-19 in Portugal provides relevant data for establishing effective strategies in future epidemics.info:eu-repo/semantics/publishedVersio
Infeção VIH e SIDA em Portugal – 2023
No full textContributos: - DGS: Programa Nacional para as Infeções Sexualmente Transmissíveis e Infeção pelo VIH (Joana Bettencourt, Alexandre Gomes); Direção de Serviços de Informação e Análise (Pedro Pinto Leite, Vitor Cabral Veríssimo).
- INSA: Departamento de Doenças Infeciosas (Helena Cortes Martins, Celeste Moura); Departamento de Epidemiologia (Carlos Aniceto).V2 (jan 2024), com pequenas correções de gralhas e ajustes de paginação.Este relatório conjunto da DGS e INSA apresenta os dados mais recentes da vigilância epidemiológica
da infeção por VIH em Portugal, bem como os resultantes de iniciativas de prevenção, rastreio e no
contexto do estigma e da discriminação desenvolvidas no âmbito do PNISTVIH.
Em Portugal, segundo os dados recolhidos a 30 de junho de 2023, foram notificados 804 casos em que
o diagnóstico de infeção por VIH ocorreu em 2022 (7,7 casos/105
habitantes), valor não ajustado para o
atraso da notificação. A maioria dos casos ocorreu em homens (3,1 casos por cada caso em mulheres).
A mediana das idades ao diagnóstico foi de 37,0 anos e 27,9% dos casos referiam idades inferiores a
30 anos, a maioria dos quais (71,6%) correspondentes a homens que têm sexo com homens (HSH). A
taxa de diagnóstico mais elevada registou-se no grupo etário 25-29 anos, 21,7 casos/105
habitantes,
em particular nos homens (35,6 casos/105
habitantes). A residência de 39,1% dos indivíduos situava-se
na Área Metropolitana de Lisboa (10,8 casos/105
habitantes) e a região do Algarve apresentou a se gunda taxa mais elevada de diagnósticos (7,0 casos/105
habitantes). A maioria dos novos casos (51,7%)
ocorreu em indivíduos naturais de Portugal, país que foi indicado como local de provável contágio
em 73,6% dos casos com essa informação. A transmissão por via sexual foi referida em 91,9% dos
casos com diagnóstico em 2022, sendo a heterossexual a mais frequente (47,7%). Os casos em HSH
constituíram 61,8% dos novos diagnósticos em homens. Na primeira avaliação clínica predominaram
os casos assintomáticos, contudo, em 12,1% houve um diagnóstico concomitante de SIDA, 57,2% apre sentaram-se com contagens de TCD4+<350 células/mm3
proporção que se revela mais elevadas nos
casos de homens que referiam transmissão heterossexual, 68,1%. Durante o ano 2022 foram também
diagnosticados 138 novos casos de SIDA (1,3 casos/105
habitantes), sendo a pneumocistose a doença
definidora de SIDA mais frequente, sendo referida em 26,8% dos casos. Foram ainda notificados 151
óbitos ocorridos em 2022, sendo que em 51,7% destes o diagnóstico da infeção por VIH tinha ocorrido
há mais de 15 anos.
Nas quatro décadas da epidemia VIH (1983-2022), foram notificados em Portugal 66 061 casos de infe ção, dos quais 23 637 atingiram estádio SIDA. Entre 2013 e 2022 observou-se uma redução de 56% no
número de novos casos de infeção por VIH e de 74% em novos casos de SIDA. Uma vez que os totais
relativos a 2022 não estão ajustados para o atraso na notificação, estes valores são provisórios. Não
obstante a tendência decrescente sustentada, Portugal continua a apresentar taxas de novos casos de
infeção por VIH e SIDA muito superiores aos valores médios registados no conjunto de países da União
Europeia.
As estimativas realizadas para o ano 2021 revelaram que, em Portugal, viviam 45 532 pessoas com infe ção por VIH, 94,4% das quais estavam diagnosticadas. A proporção de infeções não diagnosticadas era
mais elevada para os casos em homens heterossexuais (8,7%) e mais baixa em utilizadores de drogas
injetadas (UDI) (1,3%). Nesse ano, análise o tempo médio entre a infeção e o diagnóstico foi 3,7 anos.
À semelhança do observado em anos anteriores, mantem-se uma elevada percentagem de diagnósti cos tardios, com particular expressão entre os homens heterossexuais e as pessoas com 50 ou mais
anos, o que reforça a necessidade de incrementar o desenvolvimento de ações dirigidas à prevenção
da transmissão e promoção do diagnóstico precoce dirigidas a essas populações específicas. Os HSH
jovens e os migrantes de ambos os sexos devem também poder beneficiar de ações dirigidas, com
especial foco na prevenção e no rastreio.
Em 2022, foram distribuídos, através do PNISTVIH, cerca de cinco milhões de preservativos externos
e internos e mais de um milhão e seiscentas mil embalagens de gel lubrificante. O Programa Troca de
Seringas (PTS) que assinala este ano, 30 anos desde a sua implementação, permitiu a distribuição de mais de sessenta e quatro milhões de seringas entre a população UDI. No que diz respeito à Profilaxia
Pré-Exposição (PrEP) ao VIH, 2022 registou um aumento significativo no número de pessoas abran gidas por esta importante estratégia de prevenção, atingindo-se um total de cerca de quatro mil e
quinhentas pessoas, maioritariamente homens e que referem práticas sexuais com outros homens.
Foram realizados cerca de setenta mil testes rápidos para VIH em diversas estruturas de saúde e es truturas comunitárias, verificando-se um aumento significativo do número de testes rápidos realizados,
em comparação com o ano de 2021. Adicionalmente, em 2022 foram prescritos mais de trezentos e
setenta mil testes no âmbito dos cuidados de saúde primários e dispensadas mais de doze mil unida des de autoteste para VIH pelas farmácias comunitárias, entre outubro de 2019 e dezembro de 2022.
Pese embora se tenham verificado melhorias nos últimos anos, o estigma e a discriminação experien ciados pelas PVVIH persistem em Portugal, com quatro em cada dez pessoas a referirem terem sido
alvo de algum tipo de discriminação social e 15% já sofreram alguma situação de violação dos seus
direitos, de acordo com dados recolhidos através do Índice do Estigma das Pessoas que Vivem com
VIH (Stigma Index), em 2021 e 2022.This report is a joint publication from the Directorate-General of Health and the National Institute of
Health Doutor Ricardo Jorge and presents updated HIV surveillance data from Portugal and information
on national prevention and testing initiatives.
In Portugal, 804 new HIV infection cases were diagnosed in 2022, corresponding to a rate of 7.7 new ca ses/105
inhabitants, not adjusted for reporting delay. Those diagnoses were 3.1 times more frequent in
men than in women. The median age of recently diagnosed individuals was 37.0 years; 27.9% were less
than 30 years old, 71,6% of whom were men who have sex with men (MSM), which presented the lowest
median age (31.0 y/o). The highest diagnosis rates occurred among the 25-29 y/o age group (21.7 ca ses/105
inhabitants), particularly in men (35.6 cases/105
inhabitants). Lisbon Metropolitan Area was the
residence area for 39,1% of persons with a new diagnosis of HIV infection (10.8 cases/105
inhabitants),
and the second largest rate of diagnoses was identified in the Algarve region (7.0 cases/105
inhabitants).
Most cases occurred in individuals born in Portugal (51.7%), which was also the country more frequently
referred to as the probable country of infection (73.6%). Sexual transmission was reported in 91.9% of
cases; although cases of heterosexual transmission prevailed (47.7%), cases in MSM account for 61.80%
of the new diagnoses between men. At the first clinical appointment the majority of new patients were
asymptomatic, however, CD4 counts were <350 cells/mm3
in 57.2% of cases, the highest proportions
observed among heterosexual men (68.1%). In 2022, 138 new AIDS cases were diagnosed in individuals
aged ≥15 years (1.3 cases/105
inhabitants). Pneumocystosis was the most frequent AIDS-defining illness,
reported in 26.8% of AIDS cases. In the same period, 151 deaths occurred in people with HIV infection,
51.7% of those deaths happening more than fifteen years after HIV diagnosis.
In the four decades of the HIV epidemic (1983-2022), 66 061 cases of HIV infection were cumulatively
reported in Portugal, of those 23 637 were AIDS cases. Although 2022 data are not adjusted for re porting delay, temporal trends show that between 2013 and 2022 both new HIV and AIDS diagnoses
have declined, respectively 56% and 74%. Despite the downward trend, Portugal still exhibits one of the
highest rates of new HIV and AIDS diagnosis among European Union countries.
National estimates revealed that 45 532 persons were living with HIV in Portugal by the end of 2021,
5,6% of those undiagnosed. The highest proportion of undiagnosed infections was found to be among
heterosexual males (8.7%) and the lowest among IDU (1.3%). The estimated mean time from infection to
diagnosis was 3.7 years.
The maintained high proportion of late diagnoses, particularly among heterosexual men and persons
aged 50 or plus years, highlights the need of specific prevention activities and routine HIV testing Young
MSM and migrant men and women could also benefit from targeted initiatives to promote prevention
and testing.
National Programme for STI and HIV activities concerning prevention during 2022 included the supply
of more than 5 million of external and internal condoms and 1 million 600 thousand lubricants. 2022
marks the 30th anniversary of the needle exchange programme in Portugal, allowing the distribution
of more than 64 million syringes among injecting drug users’ population. Regarding Pre-Exposure Pro phylaxis, 2022 registered a significant increase in the number of people covered by this important
prevention strategy, reaching more than 4,5 thousand people, mostly men who have sex with men. HIV
rapid testing performed in several settings including primary healthcare sector and community-based
organizations, counted more than 70 thousand, representing an increasing trend compared to 2021.
Additionally, more than 3 hundred and 70 thousand HIV tests were prescribed, and a more than 12
thousand HIV self-tests were sold by community pharmacies from October 2019 until December 2022.
Even though progress has been registered in recent years, stigma and discrimination experienced by
PLWHIV still persist; In Portugal 4 out of 10 people reported some kind of social discrimination, and
15% of PLWHIH have already experienced human rights violations, according to People Living with HIV
Stigma Index, 2021 – 2022.info:eu-repo/semantics/publishedVersio
Nutritional Composition of Ultra-Processed Plant-Based Foods in the Out-of-Home Setting: A Case-Study with Vegan Burgers
No full textAbstract publicado em: Proceedings.2023;91(1):4. doi: 10.3390/proceedings2023091004Ultra-processed plant-based foods, such as plant-based burgers, have gained popularity and are perceived by consumers as a healthier and more environmentally sustainable alternative to animal-based foods. However, evidence regarding their nutritional profile and environmental sustainability is still evolving. To contribute to the understanding of the nutrient profile of ultra-processed plant-based foods in the out-of-home environment. Cities in four WHO European Member States were selected for study in a convenience sample across the regions of Amsterdam, Copenhagen, Lisbon, and London. Plant-based burgers available at selected out-of-home sites were randomly sampled. In total 41 plant-based burgers were lab-analyzed for their energy, macronutrients, amino-acids and minerals content per 100 g and per serving size. Descriptive data were used to summarize the nutritional composition per 100 g and serving size. The content per serving was compared to the appropriate reference values. The median energy content was 234 kcal/100 g (IQR = 50). Median macronutrient composition was 20.8 g/100 g (IQR = 5.7) carbohydrates and 3.5 g/100 g (IQR = 1.8) dietary fibre. Protein content was 8.9 g/100 g (IQR = 3.7) with low protein quality. The median total fat content was 12.0 g/100 g (IQR = 4.2), including 0.08 g (IQR = 0.05) TFA and 2.2 g (IQR = 2.3) SFA. The median sodium content was 389 mg/100 g (IQR = 113), equivalent to 2.7 g salt. When compared with reference values, the median serving of plant-based burgers (280 g) provided 31% of energy intake and contributed 17–28% of carbohydrates, 42% of dietary fibre, 40% of protein, and 48% of total fat including 26% of SFA. The burgers had low-quality protein. One serving provided 15–20% of the reference values for calcium, potassium, and magnesium, while higher contributions were found for zinc (30%), manganese (38%), phosphorus (51%), and iron (67%). Ultra-processed plant-based foods, such as plant-based burgers, provide protein, dietary fibre, and essential minerals. They also contain high levels of energy, sodium, and fatty acids. Despite their potential as a source of protein, the quality of protein in plant-based burgers is low. The multifaceted nutritional profile of plant-based burgers highlights the need for manufacturers to implement improvements to better support healthy dietary habits. These improvements should include reducing salt and fatty acids while also enhancing protein quality.info:eu-repo/semantics/publishedVersio
Diagnóstico de Hemoglobinopatias em Sangue de Cordão Umbilical
Get PDFFolheto técnico sobre o diagnóstico de hemoglobinopatias em sangue de cordão umbilical. As hemoglobinopatias são das doenças hereditárias autossómicas recessivas mais comuns em todo o mundo. São causadas
por mutações genéticas, que dão origem à presença de uma variante estrutural de hemoglobina (Hb) ou à diminuição da
síntese de uma ou mais cadeias da globina (talassémias). A variante de hemoglobina mais comum é a HbS que, em
homozigotia/composto genético, dá origem a anemia das células falciformes ou síndromes drepanocíticos.N/
Avaliação Bioquímica e Diagnóstico Molecular da Dislipidémia
Get PDFFolheto técnico sobre a avaliação bioquímica e dagnóstico molecular da dislipidémia. A Dislipidémia é um dos fatores de risco cardiovascular mais importantes e prevalentes na
nossa população. A sua caracterização é importante para definir o risco cardiovascular de
um indivíduo.
O Departamento de Promoção da Saúde e Prevenção de Doenças Não Transmissíveis (DPSPDNT) oferece uma série de serviços diferenciados e inovadores, além das determinações usuais de rotina, para a avaliação e caracterizaçãoda dislipidemia, dando suporte à decisão terapêutica e sua monitorização.N/
Safety and efficacy of the feed additive Anpro consisting of a mixture of Sepiolite and Kieselguhr (diatomaceous earth) for all terrestrial animal species (Anpario plc)
Get PDFFree PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10733796/Following a request from the European Commission, EFSA was asked to deliver a scientific opinion on the safety and efficacy of the mixture of Sepiolite and Kieselguhr (diatomaceous earth) (Anpro) as a technological feed additive for all terrestrial animal species. According to the conventional risk assessment, due to lack of adequate data, the safety of the additive Anpro for the target species cannot be established. Based on current knowledge, there is no indication of substantial absorption of the components of the additive and therefore no concern for the consumer. The additive poses a risk by inhalation. It is not irritant to the skin or eyes but should be considered as skin sensitiser. As no suitable data in line with the requirements of the Guidance on risk assessment of nanomaterials were provided by the applicant, the potential risks associated with the presence of nanoparticles could not be assessed for the target species, the consumer and the user. The additive is safe for the environment. The FEEDAP Panel is not in the position to conclude on the efficacy of the additive for all terrestrial animal species.info:eu-repo/semantics/publishedVersio
Impacto da COVID-19 na incidência de hospitalizações por lesões autoinfligidas em Portugal
No full textResumo publicado em Gaceta sanitária: Gac Sanit. 2023;37(Issue S1): S242. https://www.gacetasanitaria.org/es-pdf-X0213911123036410?local=trueCom o início da pandemia de COVID-19, a realidade até então conhecida mudou para muitas pessoas. A falta de convivência com familiares e amigos, insegurança, ansiedade, medo de contrair a infeção, problemas económicos decorrentes da pandemia e luto pelos familiares e amigos que perderam e dos quais não se puderam despedir devido às restrições, podem aumentar os riscos para a saúde mental e consequentemente para lesões autoinfligidas e até suicídio. O objetivo deste estudo é conhecer o o impacto de 19 meses de COVID-19, desde março de 2020 a setembro de 2021, na incidência mensal de hospitalizações por lesões autoinfligidas em Portugal. quando comparado com o período de 32 meses pré-pandémicos, desde julho de 2017 a fevereiro de 2020. Os dados sobre a ocorrência de hospitalizações são provenientes da base de dados de morbilidade hospitalar da ACSS e os denominadores populacionais para o cálculo da taxa de incidência foram obtidos do INE. Foi realizada uma análise descritiva dos dados e decomposta a série temporal pela sazonalidade e tendência. Para a comparação das tendências nos dois períodos foi aplicada uma análise de séries temporais interrompidas cuja intervenção considerada foi o mês de março de 2020 em que houve o primeiro caso de COVID-19 registado em Portugal. Foi realizada também uma análise de correlação entre o número de hospitalizações por lesões autoinfligidas e a duração nos locais de residência. A taxa de incidência mensal de hospitalizações por lesões autoinfligidas por 100 000 habitantes no período total em análise é de 2.77, no período pré-pandémico é de 2.93 e no período pandémico é de 2.49 hospitalizações, verificando-se uma diminuição de 0.45 Verificou-se um padrão sazonal, apresentando o mês de dezembro valores inferiores aos restantes meses do respetivo ano. No período pré-pandémico o número de hospitalizações apresentava uma tendência ligeiramente decrescente, com uma diminuição de 0.09% a cada mês. Quando a pandemia iniciou verificou-se uma diminuição do nível de 69.27% e uma alteração da tendência para crescente, aumentando 2.13% a cada mês. Verificou-se que o número de hospitalizações é menor quando há uma maior permanência nos locais de residência, ou seja, existe uma correlação negativa de -0.65 estatisticamente significativa (valor-p= 0.002). Nesta análise verificou-se com o início da pandemia uma diminuição acentuada das hospitalizações por lesões autoinfligidas, que ao longo do tempo parece retomar a tendência pré-pandémicaN/
Monitoring COVID-19 and Influenza: The Added Value of a Severe Acute Respiratory Infection Surveillance System in Portugal
Get PDFBackground: Severe acute respiratory infections (SARI) surveillance is recommended to assess the severity of respiratory infections disease. In 2021, the National Institute of Health Doutor Ricardo Jorge, in collaboration with two general hospitals, implemented a SARI sentinel surveillance system based on electronic health registries. We describe its application in the 2021/2022 season and compare the evolution of SARI cases with the COVID-19 and influenza activity in two regions of Portugal.
Methods: The main outcome of interest was the weekly incidence of patients hospitalized due to SARI, reported within the surveillance system. SARI cases were defined as patients containing ICD-10 codes for influenza-like illness, cardiovascular diagnosis, respiratory diagnosis, and respiratory infection in their primary admission diagnosis. Independent variables included weekly COVID-19 and influenza incidence in the North and Lisbon and Tagus Valley regions. Pearson and cross-correlations between SARI cases, COVID-19 incidence and influenza incidence were estimated.
Results: A high correlation between SARI cases or hospitalizations due to respiratory infection and COVID-19 incidence was obtained (ρ = 0.78 and ρ = 0.82, respectively). SARI cases detected the COVID-19 epidemic peak a week earlier. A weak correlation was observed between SARI and influenza cases (ρ = -0.20). However, if restricted to hospitalizations due to cardiovascular diagnosis, a moderate correlation was observed (ρ = 0.37). Moreover, hospitalizations due to cardiovascular diagnosis detected the increase of influenza epidemic activity a week earlier.
Conclusion: In the 2021/2022 season, the Portuguese SARI sentinel surveillance system pilot was able to early detect the COVID-19 epidemic peak and the increase of influenza activity. Although cardiovascular manifestations associated with influenza infection are known, more seasons of surveillance are needed, to confirm the potential use of cardiovascular hospitalizations as an indicator of influenza activity.The data of the study were originally collected as part of the project “Establishing Severe Acute Respiratory Infections (SARI) surveillance and performing hospital-based COVID-19 transmission studies,” and the “Vaccine Effectiveness, Burden, and Impact Studies (VEBIS) of COVID-19 and Influenza,” funded by the European Centre for Disease Prevention and Control through a service contract with Epiconcept (ECD.11236 and Amendment Nos. 1 ECD.11810 and ECDC/2021/016).info:eu-repo/semantics/publishedVersio