| BackgroundAs one of the important institutions to start the prevention and early warning,the fever clinic is an important link in the prevention and control of severe infectious diseases.Existing studies have shown that the monitoring of fever and respiratory symptoms through fever clinics has played an important role in the prevention and control of COVID-19(COVID-19),but the existing research on the impact of the normal prevention and control on other major infectious diseases such as seasonal influenza is sparse.How to detect and diagnose seasonal influenza in fever clinics under the normal epidemic prevention and control needs to be further discussed.ObjectiveBy comparing the monitoring situation of respiratory symptoms in fever outpatients before and after COVID-19,and the screening results of laboratory diagnosed influenza patients,clarify the epidemic situation before and after seasonal influenza;discuss the early warning effect of respiratory infectious diseases;analyze the impact of protective measures against COVID-19 on seasonal influenza;and study the response strategies of fever clinics on seasonal influenza during normal epidemic prevention and control.MethodsThe clinical data of the patients treated in the fever clinic of GUANGZHOU FIRST PEOPLE’S HOSPITAL in Nansha(Nansha Hospital)from January 01,2018 to August 31,2022 were collected,and the epidemiological characteristics and statistical analysis were conducted in two periods(January 2018 to December 2021,January to August 2022).Data were statistically processed with SPSS25.0 software,and P <0.05 was considered as a statistically significant difference.Results1.General condition of patients from January 2018 to August 2022:A total of51,367 patients were included,mainly young people(83.94%),mainly male(58.14%);low fever was common,accounting for 52.29%.2.Analysis of fever outpatients,influenza-like cases,and laboratory-diagnosed influenza patients from 2018-2021:2.1Case data: A total of 30,257 patients were included,accounting for 6.48% in2018,11.24% in 2019,35.86% in 2020,and 46.42% in 2021.The mean age was 31.97± 13.21.Influenza-like cases were 10,955,accounting for 36.21%.Laboratory diagnosed 898 influenza patients,accounting for 2.97%.Overall patients,influenzalike cases and laboratory-diagnosed influenza patients were mainly young people and men,with the young group accounting for 83.01%,84.67% vs.88.98%,while men and 59.34%,58.52% vs.58.57%,respectively.2.2Clinical symptoms: The median body temperature of the patient treated was38.05(37.50,38.50)℃.Overall patients with low fever were common(52.35%),while influenza-like cases and laboratory-diagnosed influenza patients were mostly in the middle fever group(77.63% vs.63.14%).The overall clinical manifestations offever(100.00%),sore throat(44.54%)and cough(34.67%)were the most common in overall patients.Common symptoms in influenza-like cases and laboratory diagnoses in influenza patients are fever,headache,sore throat,cough,and muscle soreness.2.3Blood routine + C reactive protein test: blood routine + C reactive protein test results of overall patients,influenza-like cases and laboratory diagnosed influenza patients(P> 0.05),so clinicians cannot diagnose or rule out influenza solely based on blood routine + C reactive protein results.2.4Influenza antigen testing: 6,511 cases of influenza antigen testing,accounting for 21.52% of the total patients and 59.43% of ILI cases.Influenza antigen,898 people tested positive,with a positive rate of 13.79%.Among them,364 cases were influenza A,accounting for 40.53%,and 534 cases were influenza B,accounting for59.47%.3.Comparison of influenza outpatients,influenza-like cases,and laboratorydiagnosed influenza patients beofor and after COVID-19:3.1The number of patients seen after the COVID-19 outbreak was significantly higher than that before the outbreak(24,896 v s.5361,P <0.05),and it increased year by year.3.2Patients treated before and after COVID-19 were mainly young and male,with no statistical difference between the groups(P> 0.05).3.3Low-fever patients after the COVID-19 outbreak increased significantly compared with the pre-epidemic outbreak period(59.66% vs.18.35%,P <0.05).3.4After the COVID-19 outbreak,the number of influenza-like cases increased year by year,but the proportion decreased significantly(68.77% vs.29.19%,P <0.05).3.5After the COVID-19 outbreak,the number of laboratory-diagnosed influenza patients decreased significantly(211 vs.687,P <0.05);the proportion of influenza patients visited patients decreased significantly from 5.56% in 2018,16.99% in2019,0.87% in 2020 and 0.83% in 2021(P <0.001).Influenza B viruses were mainly used in 2018,2019 and 2021,and mainly influenza A viruses were used in 2020.4.Time distribution of fever outpatients,influenza-like cases and laboratorydiagnosed influenza patients from 2018 to 2021: Time distribution trend of influenzalike cases and residual fever clinic patients of laboratory-diagnosed influenza patients was consistent between 2018 and 2021.5.Analysis of fever outpatients,influenza-like cases,and laboratory-diagnosed influenza patients from January 2022 to August 2022:5.1Case data: 21110 patients were included,with a mean age of 32.49 ± 12.88 years,mainly 85.28% and men,56.41%.There were 9,371 influenza-like cases,or44.39%,the youth group,84.37%,and the male group,57.48%.Laboratory diagnosis of 1625 influenza cases,accounting for 7.70%,youth group,85.23%,and male group,58.34%.5.2Clinical symptoms: The median body temperature of the overall treated patients was 38.00(37.50,38.50)℃,low fever was common(52.21%),and the common symptoms were fever(100.00%),headache(63.27%),sore throat(60.47%),cough(47.38%),and muscle soreness(37.24%).Fever dominated the influenza-like cases,accounting for 65.19%,and the common symptoms were fever(100.00%),sore throat(64.89%),cough(57.35%),headache(38.28%),and muscle soreness(23.28%).Laboratory diagnosed influenza patients with low fever,accounting for 50.95%,the common symptoms are fever(100.00%),headache(65.29%),sore throat(58.34%),muscle soreness(48.34%)and cough(34.59%).Statistical differences between the three groups(P <0.001).5.3Influenza antigen testing: 4503 cases,accounting for 21.33%,1625 influenza antigen positive cases,36.09%,1290 influenza A cases,accounting for 79.38%,335 influenza B cases,accounting for 20.62%.5.4Patients were concentrated in June and July,with 9662 patients,or 45.77%,and 1236 laboratory-diagnosed influenza cases,or 76.06%.5.5From June to July 2022,compared with the same period in previous years,the number of patients treated and the number of laboratory-diagnosed influenza all increased significantly.5.6From June to July 2022,the positive rate of influenza test in the fever clinic of Nansha Hospital was significantly higher than the national level(47.12% vs.22.65%,P <0.05).The peak rate of influenza antigen detection(24 weeks vs.27 weeks)and the peak rate of influenza positive detection(24 weeks vs.28 weeks)were 3-4 weeks earlier than those of the whole national hospital.6.The number of monthly visits to the fever clinic and the number of monthly ILI cases were changed in the same direction,and were highly correlated(r=0.727,P<0.001).There was no significant correlation between the monthly number of fever clinic visits and the monthly laboratory-diagnosed influenza patients(r=-0.145,P=0.324> 0.05).The number of monthly ILI cases and laboratory-diagnosed influenza were changed in the same direction(r=0.279,P=0.055> 0.05).The number of monthly ILI cases in the fever clinic and the number of monthly influenza antigentested influenza cases changed in the same direction and were highly correlated(r=0.607,P <0.001).Conclusion1.The fever outpatients in Nansha District of Guangzhou were mainly young and men,mainly with low fever and respiratory symptoms.2.Symptoms monitoring in fever clinic is of important value to the early warning of respiratory infectious diseases.3.Public prevention and personal control measures against COVID-19 have effectively reduced the spread of seasonal influenza,but there are still local pandemics.4.In the period of regular epidemic prevention and control,key groups are of important value to the active pre-influenza antigen testing,paying close attention to the national influenza monitoring network,and promoting regular influenza vaccination for seasonal influenza prevention and control. |
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