1. New Preprint ❕
Syndromic surveillance for severe acute respiratory infections (SARI) enables valid estimation of #COVID19 hospitalization incidence & reveals underreporting of hospitalizations during pandemic peaks of 3 waves in 🇩🇪, 2020-2021: medrxiv.org/content/10.110… See🧵⬇️
Syndromic surveillance for severe acute respiratory infections (SARI) enables valid estimation of #COVID19 hospitalization incidence & reveals underreporting of hospitalizations during pandemic peaks of 3 waves in 🇩🇪, 2020-2021: medrxiv.org/content/10.110… See🧵⬇️
2. #Syndromic surveillance: Used to inform pandemic influenza severity assessments (PISA), to assess transmissibility, seriousness of disease & impact on health systems. These indicators, developed in preparation for a potential new influenza pandemic, can be adapted for #COVID19
3. Ongoing surveillance of severe #COVID19 is essential to assess disease seriousness. The actual burden of hospitalization & intensive care treatment in COVID-19 is difficult to determine, as valid data on hospitalized cases is neither easy to get nor interpret.
4. In 🇩🇪, a mandatory reporting system for #COVID19 collects a range of epidemiological info on lab confirmed #SARSCoV2 cases, including hospitalization, ICU & death. Hospitalization info not always obtainable as follow-up of cases by the local public health authorities required.
5. The syndromic hospital surveillance system #ICOSARI (ICD10 based hospital sentinel for severe acute respiratory infections) established in 2015 also provides data. ICOSARI includes 72 acute care hospitals in 13/16 fed. states & covers about 6% of hospitalized patients in 🇩🇪.
6. Since March 2020 #RKI has enhanced its SARI monitoring to daily data transfers including preliminary ICD-10 codes of hospitalized patients. In particular, analyses expanded to include the ICD-10 code for laboratory confirmed #COVID19 cases with SARI (COVID-SARI cases).
7. The incidence estimation for #COVID-SARI and COVID-SARI with intermediate/intensive care treatment (COVID-SARI ICU) is based on data from the #ICOSARI sentinel: primary & secondary diagnoses for SARI (J09-J22) of COVID-19 cases with admissions from weeks 10/2020 to 23/2021. 
8. It can be deduced that the burden of hospitalized #COVID19 cases was much larger in the second & third wave compared to the first wave. However, the extent of hospitalization burden was considerably larger when using the data on SARI cases compared to the notification data.
9. Intensive care incidence is remarkably lower in the notification data. Considering the high proportion of unknown hospitalization status during the second & third wave, underreporting of #COVID19 hospitalizations during & of ICU treatment in theses waves can be assumed.
10. #RKI analysis shows that the hospital sentinel provides more complete data on #COVID-SARI in times when the pressure on the health system is very high, as was observed during the second and third #COVID19 waves.
11. The method for the estimation of hospitalization & intensive care incidence from sentinel data can be applied not only in the #COVID19 pandemic. Continuous surveillance of severe is essential in the transition from a #pandemic to an endemic disease
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