Considering Interim Interventions to Control COVID-19 Associated Morbidity and Mortality-Perspectives

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• COVID-19 presents significant global mortality and morbidity.
• Influenza (H1N1) and Streptococcus pneumoniae vaccines are available.
• SARS-CoV-2 shares evolutionary and antigenic similarities with influenza viruses.

Purpose of the Study:

• To analyze COVID-19 severity in adults aged 65+ in relation to influenza (H1N1) vaccination.
• To correlate lower respiratory tract infections (LRIs) and influenza-attributable LRI incidence with COVID-19 mortality.
• To explore the potential of influenza vaccination as a strategy to mitigate COVID-19.

Main Methods:

• Correlated influenza vaccination data from 34 OECD countries with COVID-19 mortality data.
• Analyzed the relationship between LRIs (influenza and Streptococcus pneumoniae) and COVID-19 mortality.
• Utilized linear regression, logistic regression, and Receiver Operating Characteristic (ROC) curve analyses on data from 182 countries.

Main Results:

• A protective correlation was observed between influenza vaccination status and COVID-19 mortality, morbidity, and incidence.
• Countries with lower influenza immunization rates showed a correlation between LRIs and increased COVID-19 severity.
• ROC analysis indicated that a decreasing trend in influenza LRI episodes could predict COVID-19 mortality (AUC=0.86 for >150/million; AUC=0.94 for >1000/1000 ratio).

Conclusions:

• Influenza (H1N1) vaccination can serve as an interim measure to reduce COVID-19 severity.
• Streptococcus pneumoniae vaccination may be a valuable adjunct strategy for high-risk populations, particularly in regions with low LRI incidence.