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. 2021 Mar 20;21(1):283.
doi: 10.1186/s12879-021-05985-0.

Divergences on expected pneumonia cases during the COVID-19 epidemic in Catalonia: a time-series analysis of primary care electronic health records covering about 6 million people

Ermengol Coma  1 , Leonardo Méndez-Boo  2 , Núria Mora  2 , Carolina Guiriguet  2   3 , Mència Benítez  2   3 , Francesc Fina  2 , Mireia Fàbregas  2 , Elisabet Balló  2   4 , Francisa Ramos  2 , Manuel Medina  2 , Josep M Argimon  5
Affiliations

Divergences on expected pneumonia cases during the COVID-19 epidemic in Catalonia: a time-series analysis of primary care electronic health records covering about 6 million people

Ermengol Coma et al. BMC Infect Dis. .

Abstract

Background: Pneumonia is one of the complications of COVID-19. Primary care electronic health records (EHR) have shown the utility as a surveillance system. We therefore analyse the trends of pneumonia during two waves of COVID-19 pandemic in order to use it as a clinical surveillance system and an early indicator of severity.

Methods: Time series analysis of pneumonia cases, from January 2014 to December 2020. We collected pneumonia diagnoses from primary care EHR, a software system covering > 6 million people in Catalonia (Spain). We compared the trend of pneumonia in the season 2019-2020 with that in the previous years. We estimated the expected pneumonia cases with data from 2014 to 2018 using a time series regression adjusted by seasonality and influenza epidemics.

Results: Between 4 March and 5 May 2020, 11,704 excess pneumonia cases (95% CI: 9909 to 13,498) were identified. Previously, we identified an excess from January to March 2020 in the population older than 15 years of 20%. We observed another excess pneumonia period from 22 october to 15 november of 1377 excess cases (95% CI: 665 to 2089). In contrast, we observed two great periods with reductions of pneumonia cases in children, accounting for 131 days and 3534 less pneumonia cases (95% CI, 1005 to 6064) from March to July; and 54 days and 1960 less pneumonia cases (95% CI 917 to 3002) from October to December.

Conclusions: Diagnoses of pneumonia from the EHR could be used as an early and low cost surveillance system to monitor the spread of COVID-19.

Keywords: COVID-19; Coronavirus; Electronic health records; Pneumonia;public health surveillance; Primary care.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Number of new pneumonia cases observed in a 7-day period by season
Fig. 2
Fig. 2
Observed and expected (with 95% CI) new pneumonia cases in a 7-day period from September 2018 to December 2020 in Catalonia
Fig. 3
Fig. 3
Number of new pneumonia and COVID-19 cases in the previous 7-day, from 1st March 2020
See this image and copyright information in PMC

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