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
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.
Aim
To analyze 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, January 2014-December 2020. We collected pneumonia diagnoses from primary care EHR, 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: 9,909 to 13,498) were identified. We observed a second excess pneumonia period from 22 october to 15 november of 1,377 excess cases (95% CI: 665 to 2,089). In contrast, we observed two great periods with reductions of pneumonia cases in children, accounting for 131 days and 3,534 less pneumonia cases (95% CI: 1,005 to 6,064) from March to July; and 54 days and 1,960 less pneumonia cases (95% CI 917 to 3,002) 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.
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