Impact of the COVID-19 pandemic on severe community-acquired pneumonia in Reunion Island: A multicenter retrospective observational study, 2016-2021

Background The Coronavirus 2019 (COVID-19) pandemic has had a considerable impact on the incidence of severe community-acquired pneumonia (CAP) worldwide. The aim of this study was to assess the early impact of the COVID-19 pandemic on severe CAP in the Reunion Island. Material and methods This multicenter retrospective observational study was conducted from 2016 to 2021 in the hospitals of Reunion Island. The incidence of severe CAP, microorganisms, the characteristics and outcomes of patients hospitalized in intensive care unit were compared between the pre-COVID-19 period (January 1, 2016 to February 29, 2020) and the early COVID-19 period (March 1, 2020 to October 31, 2021). Results Over the study period, 389 patients developed severe CAP. The incidence of severe CAP significantly decreased between the two periods (9.16 vs. 4.13 cases per 100,000 person-years). The influenza virus was isolated in 43.5% patients with severe CAP in the pre-COVID-19 period and in none of the 60 patients in the early COVID-19 period (P Streptococcus pneumoniae was the most frequently isolated bacterial microorganism, with no significant difference between the two periods. Conclusion In Reunion Island, the COVID-19 pandemic led to a significant decrease in the incidence of influenza, which likely explains the observed decrease in the incidence of severe CAP. The pandemic had no impact on the incidence of bacterial severe CAP. The incidence of influenza needs to be closely monitored now that control measures against COVID-19 have been removed.