Respiratory syndrome cases in adults grow for the first time in four weeks, says Fiocruz

Cases of severe acute respiratory syndrome (Srag) in adults rose for the first time in adults in four weeks, according to the Infogripe bulletin this Thursday (5). The data analyzed by Fiocruz’s Covid-19 Observatory are based on records until last Saturday (30).

Hospitalizations for Srag had an increase in the long-term trend (six weeks) in 14 states: Acre, Alagoas, Amazonas, Amapá, Maranhão, Mato Grosso do Sul, Mato Grosso, Pará, Paraná, Rio Grande do Norte, Rondônia, Roraima, Rio Grande do Sul and Santa Catarina.

Goiás showed a growth trend only in the short term (three weeks).

The other states show signs of stability or a downward trend.

The increase in notifications was also verified in 11 capitals, with a sign of growth in the long-term trend: Belém (PA), Boa Vista (RR), Cuiabá (MT), Curitiba (PR), Florianópolis (SC), Maceió (AL ), Manaus (AM), Porto Alegre (RS), Rio Branco (AC), São Luís (MA) and Vitória (ES).

Another three capitals show signs of growth in the short term: Goiânia (GO), Macapá (AP) and Palmas (TO).

Previously, the sign of increase had only been seen in children, aged 0 to 4 years and 5 to 11 years. In children and adolescents aged 12 to 17 years, the last months were stable.

Now, children aged 5 to 11 and 12 to 17 years have a downward trend in new notifications of Srag, and those aged 0 to 4 years have stability.

According to data from the new bulletin, the growth in several of these locations suggests that it is no longer related to new cases of respiratory disease in children, as it had been in February and March, indicating an increase in hospitalizations in adults already in April.

Fiocruz collects information from Srag notifications from the Sivep-Gripe system, from the Ministry of Health. One or more of the following symptoms are used to classify Srag reports, which can also be caused by a number of factors, including respiratory viruses: cough, sore throat, shortness of breath, or difficulty breathing.

Furthermore, laboratory confirmation of Srag cases is used to determine which virus or etiological agent causes the syndrome. For the first time in four weeks, cases with a positive diagnosis for Sars-CoV-2 stopped the downward trend and started to rise, representing 36.6% of the samples.

The respiratory syncytial virus (RSV) continues to represent the main cause of Srag in recent months (42.9%) in the country. Such growth is mainly due to the increase in cases of respiratory diseases in children since February.

In the entire year of 2022, so far, 125,712 cases of Srag were reported, of which 66,836 (53.2%) tested positive for some virus. Among the positive cases accumulated so far, 84.1% were from Sars-CoV-2, 6.2% from RSV, 5.3% from influenza A and 0.1% from influenza B.

Until last Wednesday (4), 30,499,177 cases of Covid and 663,816 deaths were confirmed in the country, according to data collected by the state health departments by the consortium of press vehicles.

The analysis of Srags is done constantly, by epidemiological week. As they are weekly rather than daily bulletins, it was possible to verify the long-term upward trend, even if in the short-term the situation seems to be more stable in most states.

Last Friday (29), the previous bulletin released by the institution pointed to a drop in the moving averages of deaths and cases in relation to the previous two weeks. However, as Fiocruz’s assessment is based on weekly data, delays due to the two consecutive holidays in April may have caused the damming of new Srag notifications.

Marcelo Gomes, coordinator of Infogripe, explains that the analysis of Srag’s data shows that the end of April had, in fact, a change in the epidemiological scenario. “While since February we had a very expressive increase in Srag in children and in the adult population it had been falling, at the end of April we see an inversion, with Srag in children falling, a possible saturation since growth has been exhausted since start of classes, and the adult population starts to show a trend of increase in new weekly cases”, he said.

For him, Srag’s upward trend can be verified by looking with a more specific magnifying glass at the age group of those hospitalized in states, which, for now, still show no sign of increase. “For example, in the situation of São Paulo this is clearly seen. While in the state in general it is stable [a situação de Srag] because hospitalizations for children have been decreasing, looking only at the adult population has grown again. So it’s important to keep an eye out in the coming weeks for this trend,” he said.

Despite the possible rebound of Covid, experts still say it is too early to know if we will have a new wave. Anyway, Gomes says that the increase in Srag associated with Covid can be seen in the increase in mild cases.