Evidence map›Paper›PMID 41132120›Full record

SynthesisInfluenza and other respiratory viruses2025

A Systematic Review of the Markers of Severity in Acute Respiratory Infections to Inform Primary Care Surveillance.

William H Elson, Anna Forbes, Gavin Jamie, Rashmi Wimalaratna, Roger Morbey, F D Richard Hobbs, Simon de Lusignan, Jamie Lopez Bernal

Abstract readSystematic Review
In one paragraph

Synthesis in Influenza and other respiratory viruses, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

William H ElsonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-8630-1378
Anna ForbesNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Gavin JamieNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Rashmi WimalaratnaNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Roger MorbeyCentre for Public Health, Faculty of Population Health Studies, Bristol Medical School, University of Bristol, UK.ORCID https://orcid.org/0000-0001-8543-477X
F D Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Simon de LusignanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-8553-2641
Jamie Lopez BernalImmunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK.

Funding

UKHSA
6 · The paper itself

Abstract

backgroundPrimary care computerised medical records (CMR) are used to report the incidence of acute respiratory infections (ARI) for public health surveillance. These systems could increase their utility by also reporting population-level severity of ARI; however, this is rarely done.

objectivesTo identify candidate markers of ARI severity suitable for use in primary care CMR-based surveillance.

methodsWe undertook a systematic review of bibliographic databases and grey literature. Eligible studies reported characteristics for > 500 patients with ARI, severe ARI, influenza-like illness or suspected COVID-19. Studies had to report at least one potential marker of severity. A panel of clinical primary care informaticians reviewed candidate severity markers and assessed each for severity, specificity, relevance to primary care and whether it was likely to be recorded in a CMR.

resultsWe included 126 studies from 84 countries. Seventy-seven candidate severity markers were identified across 11 groups. These included four outcome groups (complications, hospital events, intensive care events and death) and seven predictor groups (symptoms, signs, scores, investigations, treatments, absenteeism and treatment-seeking behaviour). Thirty markers were considered most suitable for primary care CMR-based ARI surveillance: 7 outcomes (such as hospital admission, attendance and death) and 23 predictors (such as shortness of breath, oxygen levels, work absence and antibiotics). Predictors were generally considered more timely, as they are likely recorded during the consultation.

conclusionsThis review provides a list of severity markers that could support the development of population-level severity indicators for ARI surveillance in primary care. This could improve real-time situational awareness during respiratory outbreaks.

Indexed as

Primary Health CareRespiratory Tract InfectionsAcute DiseaseBiomarkersCOVID-19HumansInfluenza, HumanPublic Health SurveillanceSeverity of Illness IndexBiomarkerselectronic health recordsinfluenza, humanprimary health carepublic health surveillancerespiratory syncytial virusesrespiratory tract infectionsSARS‐CoV‐2systematic review

Identifiers

PMID41132120
PMCPMC12550406

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.