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Journal Article Epublish 4 citations

PubMed: 40727239 DOI: 10.1016/j.lanepe.2025.101396

Excess mortality and hospitalisations associated with respiratory syncytial virus, influenza, and COVID-19 among adults in Denmark (2015-2024): a modelling study.

Lancet Reg Health Eur 55:101396

Authors: Amanda Marie Egeskov-Cavling, Chelsea L Hansen, Caroline Klint Johannesen, Birgitte Lindegaard, Samir Bhatt, Cecile Viboud, Thea K Fischer

Affiliations

  • Department of Clinical Research, North Zealand Hospital, Hilleroed, Denmark.
  • Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
  • PandemiX Center, Department of Science and Environment, Roskilde University, Roskilde, Denmark.
  • Department of Pulmonary and Infectious Diseases, North Zealand Hospital, Hilleroed, Denmark.
  • Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Abstract

Background

Understanding the long-term epidemiology trends of RSV, influenza, and COVID-19 is essential for planning of vaccination strategies and healthcare system epidemic preparedness. This is the first study to provide a comprehensive estimation of both excess mortality and hospitalisations among adults for these respiratory viruses in a European setting. We aim to estimate excess mortality and excess hospitalisations for RSV, influenza, and COVID-19 among adults ≥18 years in Denmark from January 2015 to March 2024.

Methods

This nationwide time-trend modelling study investigates weekly mortality and hospitalisation rates surpassing the seasonal baseline for RSV, influenza, and COVID-19 among adults in Denmark. Data from the Cause of Death Register, the Danish National Patient Registry, and respiratory virus surveillance data were analysed with Generalized Additive Models (GAM) using a negative binomial likelihood function, including RSV, influenza, COVID-19 variants, and time effects to account for seasonality and trend.

Findings

We estimated 3944 RSV-attributed, 5675 influenza-attributed, and 5636 COVID-19-attributed deaths. Among adults aged 65 or older, the annual mortality rates were 31.2 per 100,000 for RSV, 42.9 for influenza, and 88.5 for COVID-19. Furthermore, we estimated annual admission rates for those aged 65 and older of 177.4 per 100,000 for RSV, 164.6 for influenza, and 398.7 for COVID-19.

Interpretation

This modelling study reveals a substantial impact of RSV on individuals aged 65 and older, with a notable increase in RSV-attributed deaths and hospitalisations in recent years likely due to expanded respiratory testing after the COVID-19 pandemic. Our findings highlight the need for increased awareness in previously considered lower-risk patients, and establish benchmarks for evaluating preventive interventions.

Funding

This study received funding from Independent Research Fund Denmark.

MeSH

Respiratory Syncytial Viruses, Mortality, Aged, Covid-19, Influenza, Human, Viruses