ArticleBMJ open2020
Excess cases of influenza and the coronavirus epidemic in Catalonia: a time-series analysis of primary-care electronic medical records covering over 6 million people.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 21 citations in OpenAlex.
- Joint Analysis of the Epidemic Evolution and Human Mobility During the First Wave of COVID-19 in Spain: Retrospective Study.JMIR public health and surveillance · 2023Article
- A semi-empirical risk panel to monitor epidemics: multi-faceted tool to assist healthcare and public health professionals.Frontiers in public health · 2023Article
- Mortality in Catalonia during the summer of 2022 and its relation with high temperatures and COVID-19 cases.Frontiers in public health · 2023Article
- HIV and SARS-CoV-2 Co-infection: Epidemiological, Clinical Features, and Future Implications for Clinical Care and Public Health for People Living with HIV (PLWH) and HIV Most-at-Risk Groups.Current HIV/AIDS reports · 2022Review
- Concordance between the Clinical Diagnosis of Influenza in Primary Care and Epidemiological Surveillance Systems (PREVIGrip Study).International journal of environmental research and public health · 2022Article
- HIV and SARS-CoV-2 Co-infection: Epidemiological, Clinical Features, and Future Implications for Clinical Care and Public Health for People Living with HIV (PLWH) and HIV Most-at-Risk Groups.Current HIV/AIDS reports · 2021Review
- Healthcare Management and Quality during the First COVID-19 Wave in a Sample of Spanish Healthcare Professionals.Nursing reports (Pavia, Italy) · 2021Article
- 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.BMC infectious diseases · 2021Article
- Time Evolution of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Wastewater during the First Pandemic Wave of COVID-19 in the Metropolitan Area of Barcelona, Spain.Applied and environmental microbiology · 2021Article
- Trend of pneumonia diagnosis in emergency departments as a COVID-19 surveillance system: a time series study.BMJ open · 2021Article
- Risk Diagrams Based on Primary Care Electronic Medical Records and Linked Real-Time PCR Data to Monitor Local COVID-19 Outbreaks During the Summer 2020: A Prospective Study Including 7,671,862 People in Catalonia.Frontiers in public health · 2021Article
- Chasing the ghost of infection past: identifying thresholds of change during the COVID-19 infection in Spain.Epidemiology and infection · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesThere is uncertainty about when the first cases of COVID-19 appeared in Spain. We aimed to determine whether influenza diagnoses masked early COVID-19 cases and estimate numbers of undetected COVID-19 cases.
designTime-series study of influenza and COVID-19 cases, 2010-2020.
settingPrimary care, Catalonia, Spain.
participantsPeople registered in primary-care practices, covering >6 million people and >85% of the population.
main outcome measuresWeekly new cases of influenza and COVID-19 clinically diagnosed in primary care. ANALYSES: Daily counts of both cases were computed using the total cases recorded over the previous 7 days to avoid weekly effects. Epidemic curves were characterised for the 2010-2011 to 2019-2020 influenza seasons. Influenza seasons with a similar epidemic curve and peak case number as the 2019-2020 season were used to model expected case numbers with Auto Regressive Integrated Moving Average models, overall and stratified by age. Daily excess influenza cases were defined as the number of observed minus expected cases.
resultsFour influenza season curves (2011-2012, 2012-2013, 2013-2014 and 2016-2017) were used to estimate the number of expected cases of influenza in 2019-2020. Between 4 February 2020 and 20 March 2020, 8017 (95% CI: 1841 to 14 718) excess influenza cases were identified. This excess was highest in the 15-64 age group.
conclusionsCOVID-19 cases may have been present in the Catalan population when the first imported case was reported on 25 February 2020. COVID-19 carriers may have been misclassified as influenza diagnoses in primary care, boosting community transmission before public health measures were taken. The use of clinical codes could misrepresent the true occurrence of the disease. Serological or PCR testing should be used to confirm these findings. In future, this surveillance of excess influenza could help detect new outbreaks of COVID-19 or other influenza-like pathogens, to initiate early public health responses.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.