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Stosic M, Plavsa D, Jovanovic V, Veljkovic M, Babic D, Knezevic A, Saponjic V, Dimitrijevic D, Rancic M, Milic M, Adzic-Vukicevic T. Factors associated with COVID-19 among hospitalized patients with severe acute respiratory infections in Serbia, 2022-2023: A test negative case-control study. PLoS One 2024; 19:e0299210. [PMID: 38498428 PMCID: PMC10947665 DOI: 10.1371/journal.pone.0299210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/07/2024] [Indexed: 03/20/2024] Open
Abstract
Severe acute respiratory infections (SARI) are estimated to be the cause of death in about 19% of all children younger than 5 years globally. The outbreak of coronaviral disease (COVID-19) caused by SARS-CoV-2, increased considerably the burden of SARI worldwide. We used data from a vaccine effectiveness study to identify the factors associated with SARS CoV-2 infection among hospitalized SARI patients. We recruited SARI patients at 3 hospitals in Serbia from 7 April 2022-1 May 2023. We collected demographic and clinical data from patients using a structured questionnaire, and all SARI patients were tested for SARS-CoV-2 by RT-PCR. We conducted an unmatched test negative case-control study. SARS-CoV-2 infected SARI patients were considered cases, while SARS CoV-2 negative SARI patients were controls. We conducted bivariate and multivariable logistic regression analysis in order to identify variables associated with SARS-CoV-2 infection. We included 110 SARI patients: 74 were cases and 36 controls. We identified 5 factors associated with SARS-CoV-2 positivity, age (OR = 1.04; 95% CI = 1.01-1.07), having received primary COVID-19 vaccine series (OR = 0.28; 95% CI = 0.09-0.88), current smoking (OR = 8.64; 95% CI = 2.43-30.72), previous SARS CoV-2 infection (OR = 3.48; 95% CI = 1.50-8.11) and number of days before seeking medical help (OR = 0.81; 95% CI = 0.64-1.02). In Serbia during a period of Omicron circulation, we found that older age, unvaccinated, hospitalized SARI patients, previously infected with SARS CoV-2 virus and those who smoked, were more likely to be SARS-CoV-2-positive; these patient populations should be prioritized for COVID vaccination.
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Affiliation(s)
- Maja Stosic
- Institute of Public Health of Serbia „Dr Milan Jovanovic Batut“, Belgrade, Serbia
| | - Dragana Plavsa
- Institute of Public Health of Serbia „Dr Milan Jovanovic Batut“, Belgrade, Serbia
| | - Verica Jovanovic
- Institute of Public Health of Serbia „Dr Milan Jovanovic Batut“, Belgrade, Serbia
| | - Marko Veljkovic
- Institute of Public Health of Serbia „Dr Milan Jovanovic Batut“, Belgrade, Serbia
| | - Dragan Babic
- Institute of Public Health of Serbia „Dr Milan Jovanovic Batut“, Belgrade, Serbia
| | - Aleksandra Knezevic
- Institute for Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vladan Saponjic
- Institute of Public Health of Serbia „Dr Milan Jovanovic Batut“, Belgrade, Serbia
| | - Dragana Dimitrijevic
- Institute of Public Health of Serbia „Dr Milan Jovanovic Batut“, Belgrade, Serbia
| | - Miljan Rancic
- World Health Organization, Country Office Serbia, Belgrade, Serbia
| | - Marija Milic
- Institute of Public Health of Serbia „Dr Milan Jovanovic Batut“, Belgrade, Serbia
- Department of Epidemiology, Faculty of Medicine, University of Pristina Temporarily Seated in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Tatjana Adzic-Vukicevic
- COVID Hospital "Batajnica", University Clinical Centre of Serbia, Belgrade, Serbia
- Clinic for Pulmonology, University Clinical Centre of Serbia, Belgrade, Serbia
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