背景:牛津皇家全科医师学院(RCGP)研究和监视中心(RSC)是欧洲最古老的哨兵系统之一,与英国卫生安全局(UKHSA)及其前身机构合作了55年。它的监测报告现在每周运行两次,由在线观测站补充。除了从具有全国代表性的一组实践中进行哨点监视之外,RSC现在也为综合征监测提供数据.
目的:本研究的目的是描述2021-2022年监测季节开始时的队列概况以及我们监测实践的最新变化。
方法:RSC的假名化初级保健数据,与医院和其他数据有关,在牛津-RCGP临床信息学数字中心举行,可信的研究环境。我们描述了截至2021年9月的RSC队列概况,分为收集病毒学和血清学标本的初级保健前哨队列(PCSC)和更大的综合征性监测一般实践(SSGPs)。我们报告了我们的抽样策略的变化,使RSC与欧洲疾病控制中心指南保持一致,然后将我们的队列的社会人口统计学特征与国家统计局的数据进行比较。我们进一步描述了2020-2021年季节(2020年第40周至2021年第39周)的流感和COVID-19疫苗覆盖率,与后者区别在于疫苗品牌。最后,我们报告了住院方面与COVID-19相关的结局,重症监护病房(ICU)入院,和死亡。
结果:作为对COVID-19的回应,RSC从2019年的500多个PCSC实践增长到2021年的1879个实践(PCSC,n=938;SSGP,n=1203)。这占英国一般做法的28.6%和人口的30.59%(17,299,780/56,550,136)。在本报告所述期间,PCSC收集了>8000个病毒学和>23,000个血清学样本。RSC人口在年龄方面广泛代表了全国人口,性别,种族,国家卫生服务区域,社会经济地位,肥胖,和吸烟习惯。RSC捕获的流感疫苗覆盖率数据(n=540万)和COVID-19,报告剂量1(n=1190万),两个(n=1100万),后者的三个(n=40万)以及品牌特异性摄取数据(阿斯利康疫苗,n=1,160万;辉瑞,n=1080万;和Moderna,n=70万)。COVID-19住院和ICU入院的中位数(IQR)为每周1181(559-1559)和115(50-174),分别。
结论:RSC在全国人口中具有广泛的代表性;其PCSC在地理上具有代表性,其SSGP新支持UKHSA综合征监测工作。该网络捕获疫苗覆盖率,并已从报告初级保健出勤率扩展到提供有关后续医院结果和死亡的数据。挑战仍然是增加病毒学和血清学采样,以及时监测所有可用疫苗的有效性和减少。
The Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) is one of Europe\'s oldest sentinel systems, working with the UK Health Security Agency (UKHSA) and its predecessor bodies for 55 years. Its surveillance report now runs twice weekly, supplemented by online observatories. In addition to conducting sentinel surveillance from a nationally representative group of practices, the RSC is now also providing data for syndromic surveillance.
The aim of this study was to describe the cohort profile at the start of the 2021-2022 surveillance season and recent changes to our surveillance practice.
The RSC\'s pseudonymized primary care data, linked to hospital and other data, are held in the Oxford-RCGP Clinical Informatics Digital Hub, a Trusted Research Environment. We describe the RSC\'s cohort profile as of September 2021, divided into a Primary Care Sentinel Cohort (PCSC)-collecting virological and serological specimens-and a larger group of syndromic surveillance general practices (SSGPs). We report changes to our sampling strategy that brings the RSC into alignment with European Centre for Disease Control guidance and then compare our cohort\'s sociodemographic characteristics with Office for National Statistics data. We further describe influenza and COVID-19 vaccine coverage for the 2020-2021 season (week 40 of 2020 to week 39 of 2021), with the latter differentiated by vaccine brand. Finally, we report COVID-19-related outcomes in terms of hospitalization, intensive care unit (ICU) admission, and death.
As a response to COVID-19, the RSC grew from just over 500 PCSC practices in 2019 to 1879 practices in 2021 (PCSC, n=938; SSGP, n=1203). This represents 28.6% of English general practices and 30.59% (17,299,780/56,550,136) of the population. In the reporting period, the PCSC collected >8000 virology and >23,000 serology samples. The RSC population was broadly representative of the national population in terms of age, gender, ethnicity, National Health Service Region, socioeconomic status, obesity, and smoking habit. The RSC captured vaccine coverage data for influenza (n=5.4 million) and COVID-19, reporting dose one (n=11.9 million), two (n=11 million), and three (n=0.4 million) for the latter as well as brand-specific uptake data (AstraZeneca vaccine, n=11.6 million; Pfizer, n=10.8 million; and Moderna, n=0.7 million). The median (IQR) number of COVID-19 hospitalizations and ICU admissions was 1181 (559-1559) and 115 (50-174) per week, respectively.
The RSC is broadly representative of the national population; its PCSC is geographically representative and its SSGPs are newly supporting UKHSA syndromic surveillance efforts. The network captures vaccine coverage and has expanded from reporting primary care attendances to providing data on onward hospital outcomes and deaths. The challenge remains to increase virological and serological sampling to monitor the effectiveness and waning of all vaccines available in a timely manner.