背景:18-64岁的成年人占工作人口的大部分,这意味着流感感染可能是破坏性的,导致长时间不在工作场所,降低了生产力和照顾家属的能力。流感疫苗的摄入量相对较低,甚至在这一人群中的老年人中(即,50-64岁),反映缺乏对疫苗接种的感知需要。本系统文献综述(SLR)旨在描述18-64岁人群中流感的全球负担。
方法:进行电子数据库搜索,并辅以会议和灰色文献检索。符合条件的研究描述了至少一项临床,人文,或18-64岁成年人的经济结果,并在几个全球地区进行。纳入的研究以英文发表,2012年1月1日至2022年9月20日。
结果:共包括40种出版物,临床,人文,和经济成果报告分别为39、5和15。据报道,在18-64岁人群中,流感相关临床结果的风险随着年龄的增加而增加。包括住院治疗(Yamana等人。实习生医学杂志60:3401-3408,2021年;Derqui等人。流感其他相关病毒16:862-872,2022;Fuller等人。流感其他相关病毒16:265-275,2022;Ortiz等人。在CritCareMed42:2325-2332,2014;Yandrapalli等人。安Transl医学杂志6:318,2018;齐默尔曼等人。其他流感病毒16:1133-1140,2022)。ICU入院,死亡率,急诊室/门诊就诊,记录机械通气的使用情况。患有潜在合并症的18-64岁成年人患流感相关住院的风险较高,入住ICU,和死亡率比其他健康的人。住院时间随着年龄的增长而增加,尽管缺乏其他经济结局的分层,但无法确定各年龄组的进一步趋势。
结论:高水平的住院和门诊量表明,对患者和医疗保健系统的临床流感相关负担,合并症加剧了这种情况。考虑到18-64岁一般人口的规模和广度,此SLR的有限的人文和经济发现可能反映了被低估的负担。需要对与流感感染相关的间接成本和长期缺勤进行更深入的调查,以充分了解该人群的经济负担。
Adults aged 18-64 years comprise most of the working population, meaning that influenza infection can be disruptive, causing prolonged absence from the workplace, and reduced productivity and the ability to care for dependents. Influenza vaccine uptake is relatively low, even among the older adults in this population (i.e., aged 50-64 years), reflecting a lack of perceived need for vaccination. This systematic literature
review (SLR) aimed to characterize the global burden of influenza in the 18-64 years population.
An electronic database search was conducted and supplemented with conference and gray literature searches. Eligible studies described at least one of clinical, humanistic, or economic outcomes in adults aged 18-64 years and conducted across several global regions. Included studies were published in English, between January 1, 2012, and September 20, 2022.
A total of 40 publications were included, with clinical, humanistic, and economic outcomes reported in 39, 5, and 15, respectively. Risk of influenza-associated clinical outcomes were reported to increase with age among the 18-64 years population, including hospitalizations (Yamana et al. in Intern Med 60:3401-3408, 2021; Derqui et al. in Influenza Other Respir Viruses 16:862-872, 2022; Fuller et al. in Influenza Other Respir Viruses 16:265-275, 2022; Ortiz et al. in Crit Care Med 42:2325-2332, 2014; Yandrapalli et al. in Ann Transl Med 6:318, 2018; Zimmerman et al. in Influenza Other Respir Viruses 16:1133-1140, 2022). ICU admissions, mortality, ER/outpatient visits, and use of mechanical ventilation were recorded. Adults aged 18-64 years with underlying comorbidities were at higher risk of influenza-related hospitalizations, ICU admission, and mortality than otherwise healthy individuals. Length of hospital stay increased with age, although a lack of stratification across other economic outcomes prevented identification of further trends across age groups.
High levels of hospitalization and outpatient visits demonstrated a clinical influenza-associated burden on patients and healthcare systems, which is exacerbated by comorbidities. Considering the size and breadth of the general population aged 18-64 years, the limited humanistic and economic findings of this SLR likely reflect an underreported burden. Greater investigation into indirect costs and prolonged absenteeism associated with influenza infection is required to fully understand the economic burden in this population.