Data were extracted from administrative databases from 2008 to 2018 that contained all NHS hospitalization records in mainland Portugal. Influenza episodes were defined as those coded with ICD-9 487 or 488; or ICD-10 J09, J10, or J11 in any primary or secondary diagnosis field. Total hospitalizations excluded admissions related to routine birth, planned activity, and those in which the primary diagnosis was related to musculoskeletal, alcoholic, or mental disease. Additional diagnostic information during the influenza episode was also used to identify individuals who had at least one medical condition regarded as a risk factor for severe influenza (Additional file 1: Table S1) in any primary or secondary diagnosis field, considering the following conditions: pregnancy, diabetes mellitus, respiratory or lung disease, cardiovascular disease, immunocompromised, chronic liver disease, and chronic kidney disease.
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