Severe Acute Respiratory Illness surveillance for COVID-19 in India

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Salient Points

This article focuses on the sentinel surveillance among SARI patients which can help identify the spread and extent of transmission of COVID-19.

The study was done on 5,911 SARI patients, out of which 104 (1.8%) were tested positive for COVID – 19. Of them, 40 patients did not report any history of contact with a known case or international travel.

Detailed Summary

For the study, 41 sentinel sites were selected to test throat/nasopharyngeal swabs from a sample of SARI patients admitted between February 15 and March 19, 2020. Aggregate data on the number of SARI patients tested and COVID-19 positivity were collected from each laboratory. Since March 20, 2020, the testing strategy was revised to include all SARI patients.

The SARS-CoV-2 laboratory test was based on the detection of unique sequences of virus RNA by nucleic acid amplification test such as real-time reverse transcription-polymerase chain reaction (RT-PCR) and targeted the SARS-CoV-2 E (envelope protein)

Results of study

  • A total of 5,911 SARI patients were tested.
  • 104 (1.8%) tested positive for COVID-19.
  • Among the 965 SARI patient samples that were tested retrospectively between February 15 – 29, 2020 and March 19, 2020, two (0.2%) were positive for COVID-19.
  • No of Foreign travel/contact with known confirmed COVID – 19 case = 39.2%
  • Contact with a known laboratory confirmed COVID-19 case = 2%
  • Patients with History of Foreign travel = 1%
  • Data not available in = 57.8%

The median age of COVID-19 positive SARI patients was 54 yr (44-63), and 85 (83.3%) were males, 83 (81.4%) of the affected patients were more than 40 y/o. Positivity was higher in males (2.3%) and in 50-70 yr of age group (4.4%).


Tracking the spread of COVID-19 is critical to inform response activities including testing, containment and mitigation measures. The current SARI testing strategy will help strengthen the routine COVID-19 surveillance activities. Information from hospital-based SARI surveillance would help in setting triggers for escalation/de- escalation of mitigation measures, identify risk groups for severe disease and measure impact of the response activities. Continued sentinel surveillance for COVID-19 among SARI patients would guide the health departments to prioritize, plan and mobilize their resources in terms of where, when and how to respond.

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