Rates of Medically Attended RSV Among US Adults: A Systematic Review and Meta-analysis.
Rates of Medically Attended RSV Among US Adults: A Systematic Review and Meta-analysis.
复制标题
DOI：
10.1093/ofid/ofac300
复制
发表时间：
2022-07
影响因子：
4.2
通讯作者：
中科院分区：
文献类型：
--
作者：
成人呼吸道合胞病毒（RSV）疫苗处于开发的后期阶段。需要对成人RSV负担进行全面综合，以便为公共卫生决策提供信息。我们对描述美国成年人中医学参与的RSV（MA-RSV）发病率的研究进行了系统回顾和荟萃分析。我们还确定了报告鼻咽（NP）或鼻拭子逆转录聚合酶链反应（RT-PCR）结果与配对血清学（4倍升高）或痰液（RT-PCR）结果的研究，以计算RSV检出率，定量增加第二种标本类型（即血清学或痰液）后提高的诊断率。我们确定了14项研究，其中有15项独特的MA-RSV发病率估计值，均基于NP或鼻拭子RT-PCR检测。每100 000例≥65岁成人的合并RSV相关年发病率为178（95% CI，152 - 204; n = 8个估计值）住院（4项前瞻性研究：189; 4项基于模型的研究：157），133（95% CI，0 - 319; n = 2）急诊科（艾德）入院，1519（95% CI，1109 - 1929; n = 3）门诊就诊。基于6项研究，当添加配对血清学或痰液时，RSV检测结果高出1.5倍。在对这一增加的产量进行调整后，每10万名年龄≥65岁的成年人的年度RSV相关率为267次住院（不确定区间[UI]，228 <$306;前瞻性：282;基于模型：236），200次艾德入院（UI，0 <$478）和2278次门诊就诊（UI，1663 <$2893）。患有慢性疾病的65岁以下的人因RSV住院的可能性为1.2 - 28倍，具体取决于风险状况。RSV的真正负担被低估了，在老年人和慢性疾病患者中很重要。一种高效的成人RSV疫苗将对公共卫生产生重大影响。
Adult respiratory syncytial virus (RSV) vaccines are in the late stages of development. A comprehensive synthesis of adult RSV burden is needed to inform public health decision-making. We performed a systematic review and meta-analysis of studies describing the incidence of medically attended RSV (MA-RSV) among US adults. We also identified studies reporting nasopharyngeal (NP) or nasal swab reverse transcription polymerase chain reaction (RT-PCR) results with paired serology (4-fold-rise) or sputum (RT-PCR) to calculate RSV detection ratios quantifying improved diagnostic yield after adding a second specimen type (ie, serology or sputum). We identified 14 studies with 15 unique MA-RSV incidence estimates, all based on NP or nasal swab RT-PCR testing alone. Pooled annual RSV-associated incidence per 100 000 adults ≥65 years of age was 178 (95% CI, 152‒204; n = 8 estimates) hospitalizations (4 prospective studies: 189; 4 model-based studies: 157), 133 (95% CI, 0‒319; n = 2) emergency department (ED) admissions, and 1519 (95% CI, 1109‒1929; n = 3) outpatient visits. Based on 6 studies, RSV detection was ∼1.5 times higher when adding paired serology or sputum. After adjustment for this increased yield, annual RSV-associated rates per 100 000 adults age ≥65 years were 267 hospitalizations (uncertainty interval [UI], 228‒306; prospective: 282; model-based: 236), 200 ED admissions (UI, 0‒478), and 2278 outpatient visits (UI, 1663‒2893). Persons <65 years with chronic medical conditions were 1.2−28 times more likely to be hospitalized for RSV depending on risk condition. The true burden of RSV has been underestimated and is significant among older adults and individuals with chronic medical conditions. A highly effective adult RSV vaccine would have substantial public health impact.
登录
查看更多内容
DOI：
10.1093/cid/ciy312
发表时间：
2018-10-30
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
McLaughlin JM;Jiang Q;Isturiz RE;Sings HL;Swerdlow DL;Gessner BD;Carrico RM;Peyrani P;Wiemken TL;Mattingly WA;Ramirez JA;Jodar L
通讯作者：
Jodar L
影响因子：
2.2
作者：
DerSimonian R;Laird N
通讯作者：
Laird N
影响因子：
6.4
作者：
Datta, Siddhant;Walsh, Edward E.;Falsey, Ann R.
通讯作者：
Falsey, Ann R.
影响因子：
12.7
作者：
Falsey, Ann R.;Walsh, Edward E.;Griffin, M. Pam
通讯作者：
Griffin, M. Pam
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N