Acute lower respiratory tract disease (LRTD) - which encompasses pneumonia, lower respiratory tract infection (LRTI), acute bronchitis, exacerbation of underlying respiratory disease including asthma and chronic obstructive pulmonary disease (COPD), as well as COVID-19 (SARS-CoV-2 infection) Respiratory Pneumonia, organism unspecified, Unspecified acute lower respiratory infection, Acute bronchitis, Asthma, Chronic obstructive pulmonary disease, unspecified
Conditions
Interventions
Adults with LRTD will be screened using population-level surveillance at study hospitals, and the collection of standard-of-care data will be performed on all LRTD events. Patients presenting during t
Sponsors
University of Bristol
Eligibility
Sex/Gender
All
Age
18 Years to 110 Years
Inclusion criteria
Inclusion criteria: 1. Aged =18 years of age 2. Patients with illness with the following two characteristics: 2.1. Acute illness (i.e., present for 28 days or less) AND 2.2. Evidence of acute LRTD: 2.2.1. Patients with current or suspected COVID-19 or previous proven COVID-19 within last 28 days OR 2.2.2. Clinical or radiologic diagnosis of pneumonia or an acute LRTI OR 2.2.3. New onset or worsening of =2 of the following eight LRTD symptoms or clinical findings: 2.2.3.1. Fever (>38.0°C) or hypothermia (<35.5°C) before or within 24 hours of enrolment 2.2.3.2. Pleuritic chest pain 2.2.3.3. Cough (including nocturnal only) 2.2.3.4. Sputum production or purulence 2.2.3.5. Dyspnea (shortness of breath) including orthopnea or on exertion only 2.2.3.6. Tachypnea (respiratory rate =20/min) documented by healthcare professional 2.2.3.7. Abnormal auscultatory findings suggestive of LRTD (e.g., crepitations/rales or evidence of pulmonary consolidation including dullness on percussion, bronchial breath sounds, wheezing, or egophony) 2.2.3.8. Radiologic finding that is consistent with LRTD, including pneumonia, and/or acute congestive heart failure (e.g., pleural effusion, increased pulmonary density due to infection, the presence of alveolar infiltrates [multilobar, lobar or segmental] containing air bronchograms, or interstitial oedema)
Exclusion criteria
Exclusion criteria: Patients meeting any of the following criteria will not be included in the study: 1. Any patient who develops signs and symptoms of LRTD after being hospitalized for =48 hours (either at current hospital, another transferring hospital, or a combination of these), unless admitted with current, previous proven, or suspected COVID-19 infection. 2. Previously enrolled participants readmitted =7 days after discharge for their study qualifying admission, unless admitted with current, previous proven, or suspected COVID-19 infection 3. At the time of enrolment, an LRTD-related diagnosis has been excluded or another diagnosis confirmed (for example, patient was found to have fever and tachypnoea due to an intraabdominal process such as cholecystitis)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The population-based incidence of community-acquired LRTI hospitalizations during and following the COVID-19 pandemic, overall and for community-acquired pneumonia, obtained from the medical admission records within participating hospitals and analysed yearly for 3 years, with interim analyses carried out as required | — |
Secondary
| Measure | Time frame |
|---|---|
| Obtained from the medical admission records within participating hospitals and analysed yearly for 3 years, with interim analyses carried out as required: COVID-19/SARS-CoV-2 infection: 1. The population-based incidence rates of COVID-19-related hospitalizations 2. The proportion of LRTI hospitalizations (overall, standard-of-care pneumonia diagnosis, radiologically confirmed CAP only) attributable to COVID-19, both overall and by age/risk stratification 3. Demographics, clinical and epidemiological characteristics and outcomes within COVID-19 LRTI and the different subcategories, both overall and stratified by age/risk 4. Mortality rate at 30 days after admission to hospital for COVID-19 LRTI and its subcategories, overall and by age group and risk group status 5. The association between COVID-19 and other respiratory pathogens, including but not limited to S. pneumoniae, influenza and RSV, both with co- and super-imposed infection and secondary respiratory infection 6. The length of hospital stay for COVID-19 LRTI hospitalizations and the proportion of COVID-19 admissions involving an ICU stay, determined by review of clinical records and medical notes on day 30 following admission 7. The association of S. pneumoniae LRTI with more severe COVID-19 clinical outcomes (such as requiring invasive mechanical ventilation) among persons hospitalised with COVID-19 infection Streptococcus pneumoniae: 1. The population-based incidence rates of hospitalizations for the following 12 specified LRTI subcategories: 1.1. All LRTI (overall, pneumococcal only, PCV13-type, and PCV20-type); 1.2. Any standard-of-care pneumonia diagnosis (overall, pneumococcal only, PCV13-type, and PCV20-type); 1.3. Any radiologically confirmed CAP (overall, pneumococcal only, PCV13-type, and PCV20-type). 2. The proportion of LRTI hospitalizations (overall, standard-of-care pneumonia diagnosis, radiologically confirmed CAP only) associated with any S. pneumoniae, PCV13, PCV20 serotypes and by indi | — |
Countries
England, United Kingdom
Contacts
Public ContactJennifer;Madeleine Oliver;Clout
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Outcome results
None listed