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DOI: 10.1016/j.rceng.2020.09.003
Available online 7 April 2021
Performance of the case definition of suspected influenza before and during the COVID-19 pandemic
Desempeño de la definición de caso sospechoso de influenza antes y durante la pandemia por COVID-19
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E. Murillo-Zamoraa, C. Hernández-Suárezb,
Corresponding author
carlosmh@mac.com

Corresponding author.
a Departamento de Epidemiología, Unidad de Medicina Familiar No. 19, Instituto Mexicano del Seguro Social, Colima, Mexico
b Facultad de Ciencias, Universidad de Colima, Colima, Mexico
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Table 1. Performance of suspected influenza case definition, Mexico 2018–2020.
Abstract
Objective

This study aimed to evaluate the performance, before and during the COVID-19 pandemic, of the case definition of suspected influenza used in community surveillance in Mexico.

Methods

A cross-sectional analysis of a cohort study was performed and cases that met the suspected case criteria (n = 20,511) and that had laboratory-conclusive evidence (quantitative real-time polymerase chain reaction) to confirm or discard influenza virus infection were analysed.

Results

A high sensitivity and modest specificity were documented, which later decreased during the COVID-19 outbreak, as well as its diagnostic accuracy. However, no significant differences were observed in the area under the receiver operating characteristics curve among the analysed periods.

Conclusions

The evaluated case definition remains to be a cost-effective alternative for identifying patients who may benefit from influenza-specific antiviral drugs, even during the global COVID-19 outbreak.

Keywords:
Influenza
COVID-19
Pandemics
ROC Curve
Mexico
Resumen
Objetivos

Este estudio tuvo como objetivo evaluar el desempeño, antes y durante la pandemia de la COVID-19, de la definición de caso de sospecha de influenza en la vigilancia comunitaria en México.

Métodos

Se llevó a cabo un análisis transversal de un estudio de cohorte y, con el fin de confirmar o descartar la infección por virus influenza, se analizaron los casos que cumplían con los criterios de caso sospechoso (n = 20.511) y con evidencia concluyente de laboratorio (reacción cuantitativa en cadena de la polimerasa en tiempo real).

Resultados

Se documentaron una alta sensibilidad y una discreta especificidad, que posteriormente disminuyó, así como su precisión diagnóstica, durante el brote de la COVID-19. Sin embargo, no se observaron diferencias en el área bajo la curva de características operativas del receptor entre los períodos analizados.

Conclusiones

La definición de caso evaluada sigue siendo una alternativa rentable para identificar a los pacientes que pueden beneficiarse de los medicamentos antivirales específicos contra la influenza, incluso durante el brote mundial de COVID-19.

Palabras clave:
Influenza
COVID-19
Pandemias
Curva de ROC
México

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