Excess mortality and hospitalisations associated with respiratory syncytial virus, influenza, and COVID-19 among adults in Denmark (2015–2024): a modelling studyResearch in context
Summary: 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 hospitalis...
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| Format: | Article |
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Elsevier
2025-08-01
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| Series: | The Lancet Regional Health. Europe |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666776225001887 |
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| author | Amanda Marie Egeskov-Cavling Chelsea L. Hansen Caroline Klint Johannesen Birgitte Lindegaard Samir Bhatt Cecile Viboud Thea K. Fischer |
| author_facet | Amanda Marie Egeskov-Cavling Chelsea L. Hansen Caroline Klint Johannesen Birgitte Lindegaard Samir Bhatt Cecile Viboud Thea K. Fischer |
| author_sort | Amanda Marie Egeskov-Cavling |
| collection | DOAJ |
| description | Summary: 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. |
| format | Article |
| id | doaj-art-54dfe1b3b2364c0a8070bbafcd94059e |
| institution | OA Journals |
| issn | 2666-7762 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Europe |
| spelling | doaj-art-54dfe1b3b2364c0a8070bbafcd94059e2025-08-20T02:38:51ZengElsevierThe Lancet Regional Health. Europe2666-77622025-08-015510139610.1016/j.lanepe.2025.101396Excess mortality and hospitalisations associated with respiratory syncytial virus, influenza, and COVID-19 among adults in Denmark (2015–2024): a modelling studyResearch in contextAmanda Marie Egeskov-Cavling0Chelsea L. Hansen1Caroline Klint Johannesen2Birgitte Lindegaard3Samir Bhatt4Cecile Viboud5Thea K. Fischer6Department of Clinical Research, North Zealand Hospital, Hilleroed, Denmark; Corresponding author. North Zealand Hospital, Dyrehavevej 29, Hilleroed, 3400, 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, DenmarkDepartment of Clinical Research, North Zealand Hospital, Hilleroed, DenmarkDepartment of Pulmonary and Infectious Diseases, North Zealand Hospital, Hilleroed, DenmarkDepartment of Public Health, University of Copenhagen, Copenhagen, DenmarkDivision of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USADepartment of Clinical Research, North Zealand Hospital, Hilleroed, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Corresponding author. Department of Clinical Research, North Zealand Hospital, Hilleroed, Denmark.Summary: 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.http://www.sciencedirect.com/science/article/pii/S2666776225001887Respiratory tract infectionsMortalityHospital admissionRSVInfluenzaCOVID19 |
| spellingShingle | Amanda Marie Egeskov-Cavling Chelsea L. Hansen Caroline Klint Johannesen Birgitte Lindegaard Samir Bhatt Cecile Viboud Thea K. Fischer Excess mortality and hospitalisations associated with respiratory syncytial virus, influenza, and COVID-19 among adults in Denmark (2015–2024): a modelling studyResearch in context The Lancet Regional Health. Europe Respiratory tract infections Mortality Hospital admission RSV Influenza COVID19 |
| title | Excess mortality and hospitalisations associated with respiratory syncytial virus, influenza, and COVID-19 among adults in Denmark (2015–2024): a modelling studyResearch in context |
| title_full | Excess mortality and hospitalisations associated with respiratory syncytial virus, influenza, and COVID-19 among adults in Denmark (2015–2024): a modelling studyResearch in context |
| title_fullStr | Excess mortality and hospitalisations associated with respiratory syncytial virus, influenza, and COVID-19 among adults in Denmark (2015–2024): a modelling studyResearch in context |
| title_full_unstemmed | Excess mortality and hospitalisations associated with respiratory syncytial virus, influenza, and COVID-19 among adults in Denmark (2015–2024): a modelling studyResearch in context |
| title_short | Excess mortality and hospitalisations associated with respiratory syncytial virus, influenza, and COVID-19 among adults in Denmark (2015–2024): a modelling studyResearch in context |
| title_sort | excess mortality and hospitalisations associated with respiratory syncytial virus influenza and covid 19 among adults in denmark 2015 2024 a modelling studyresearch in context |
| topic | Respiratory tract infections Mortality Hospital admission RSV Influenza COVID19 |
| url | http://www.sciencedirect.com/science/article/pii/S2666776225001887 |
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