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Excess hospitalisations associated with influenza, respiratory syncytial virus and SARS-CoV-2 in Singapore from 2015 to 2023
  • Chia Hui Qi,
  • Robyn Lim,
  • Rachael Pung
Chia Hui Qi
Government of Singapore Ministry of Health
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Robyn Lim
Government of Singapore Ministry of Health
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Rachael Pung
Government of Singapore Ministry of Health

Corresponding Author:rachaelpung@moh.gov.sg

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Abstract

Background The patterns of circulation and burden of influenza and respiratory syncytial virus (RSV) in Singapore are affected by the COVID-19 pandemic containment measures. These patterns in relation to SARS-CoV-2 in a post-pandemic era are unclear. Methods Using data from 2015 to 2023, we estimated excess influenza-, RSV- and SARS-CoV-2-associated hospitalisation in Singapore, adjusted for rhinovirus/enterovirus activity in generalised additive models. The data includes pneumonia and influenza (P&I) hospitalisation from a national inpatient database and a community-wide acute respiratory infection (ARI) sentinel surveillance programme, stratified by age groups. Results Across all age groups, the proportion of hospitalisation associated with influenza, SARS-CoV-2 and RSV was 15.7% (95% CI 6.4%–25.0%), 16.5% (95% CI 10.5%–22.6%) and 6.3% (95% CI 2.2%–12.5%) in 2023. From 2019 to 2023, all-age influenza-associated hospitalisation declined from 129.8 per 100,000 person-years (95% CI 110.9–148.4) to 95.7 per 100,000 person-years (95% CI 38.9–152.2). In contrast, all-age RSV-associated hospitalisation after the pandemic was 38.4 per 100,000 person-years (95% CI 13.1-75.9), similar to pre-pandemic observations. Peak seasonal influenza occurred 3-8 weeks later as compared to the time of pre-pandemic peak influenza activity. Conclusion The overall burden of influenza has declined after the COVID-19 pandemic and its burden is comparable with SARS-CoV-2. Furthermore, shifts in the timing of peak influenza activity suggest a potential need to review the timing of vaccine recommendations in Singapore.
16 Oct 2024Submitted to Influenza and other respiratory viruses
17 Oct 2024Submission Checks Completed
17 Oct 2024Assigned to Editor
18 Oct 2024Reviewer(s) Assigned
10 Dec 2024Review(s) Completed, Editorial Evaluation Pending