RFA-IP-22-001 - Burden and sequelae of influenza, SARS-CoV-2 and other respiratory viruses associated Severe Acute Respiratory Infections among Indian adult population aged 18-60yrs

Project Summary As a logical extension of the work done by the team at the All India Institute of Medical Science, New Delhi, this work will expand to include more geographically diverse sites and address adults who have not been adequately studied but who due to their productivity can dis-appropriately contribute to the overall economic burden. The proposal intends to execute a series of inter-related activities to support evidence-based policy development to address Influenza and SARSCo-V2 infection in working adult population of India. The specific objectives are to estimate the incidence and treatment cost of Influenza and SARS-CoV-2 associated Severe Acute Respiratory Infections (SARI) among adults aged 18-60 years and characterize the detected viruses; to estimate the incidence of short and long-term sequelae of Influenza and SARS-CoV-2 associated SARI and risk of re-infection; to assess vaccine hesitancy and uptake among health care workers and estimate the effectiveness of influenza and COVID-19 vaccines against serious illness and finally, conduct capacity building initiatives for health professionals and advocate for public health approach for prevention and control of influenza and COVID-19 disease in India among key stakeholders. This will be done by setting up Indian National SARI Platform for Influenza and other Respiratory Pathogens (INSPIRES) a multi-centric network of public tertiary hospitals with three components - hospital-based SARI Registry with a cohort of Influenza or COVID-19 patients with a linked community site and a cohort of healthcare workers. The platform will consist of geographically spread 10-12 medical colleges which routinely admit and manage SARI cases. The patients with severe acute respiratory infection (SARI) admitted and testing positive for identified pathogens i.e., influenza and SARS CoV-2. The community-based SARI surveillance to be conducted in the catchment area of the hospitals will estimate SARI incidence rates. Combining the two will provide agent- specific SARI rates for each participating site. A cohort of influenza and SARS CoV-2 positive patients identified above will be followed for two years after enrolment to look at pulmonary, cardiac, cognition, functional status and quality of life parameters. A cohort of health care workers in the study hospitals will be followed up for the duration of the study. After a baseline assessment of their vaccine uptake and hesitancy, they will be sensitized to the need for vaccination and offered free vaccines (both influenza and COVID-19) as per the hospital policy. All participants will be followed up for a period of two years for development of symptomatic Influenza or SARS CoV2 infection. A Respiratory viruses Resource Centre will be set up at AIIMS New Delhi to prepae training and advocacy materials for liaising with a diverse set of stakeholders ranging from general population, healthcare professionals to policy makers.