Document Type
Article
Abstract
Background
The incidence of pneumococcal pneumonia in the context of the Coronavirus Disease 2019 (COVID-19) pandemic, along with the real-world data on the ratio of non-invasive to invasive pneumococcal pneumonia, is an area that has not been thoroughly studied. The outcomes associated with coinfection of influenza and COVID-19 remain unknown. This study examined the incidence, demographics, coinfection with influenza and/or COVID-19, and clinical outcomes of pneumococcal hospitalizations in Hong Kong during the baseline, pandemic, and post-pandemic periods.
Methods
Hospitalization records of individuals aged 18 years and above with pneumococcal disease from January 2015 to August 2024 were extracted from the territory-wide electronic medical record database. Pneumococcal disease was categorized into invasive pneumococcal pneumonia (IPP), invasive pneumococcal disease without pneumonia (IPDWP), and non-invasive pneumococcal pneumonia (NIPP), followed by univariate and multivariate analyses. Effects of coinfection with influenza and COVID-19 were analyzed.
Results
The incidence of pneumococcal disease decreased during the COVID-19 pandemic but rebounded in the post-pandemic period. There were no significant changes in the distribution of pneumococcal serotypes across the three periods. The study revealed a strong positive correlation between monthly pneumococcal hospitalizations and the indicator of influenza activity, while the correlation with the COVID-19 indicator was weak. Additionally, strong positive correlations were observed between the indicator of influenza activity and influenza coinfections, as well as between the indicator of COVID-19 activity and COVID-19 coinfections. Multivariate analyses identified male gender, a higher comorbidity index, older age, invasive pneumococcal disease (IPP and IPDWP), coinfection with influenza and COVID-19, and hospitalization during the pandemic period as factors associated with adverse outcomes.
Conclusions
The study showcases changes in the epidemiology of pneumococcal disease during and after the COVID-19 pandemic. It highlights the adverse effects of influenza and COVID-19 coinfections on the outcomes of patients with pneumococcal disease and emphasizes the need to vaccinate vulnerable populations against these infections.
Digital Object Identifier (DOI)
Publication Info
Published in Pneumonia, Volume 17, 2025.
Rights
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
APA Citation
Chan, K.-P. F., Ma, T.-F., Fang, H., Tsui, W.-K., Ho, J. C.-M., Ip, M. S.-M., & Ho, P.-L. (2025). Changes in the incidence, viral coinfection pattern and outcomes of pneumococcal hospitalizations during and after the COVID-19 pandemic. Pneumonia, 17.https://doi.org/10.1186/s41479-025-00164-0