Adenovirus diseases: a systematic review and meta-analysis of 228 case reports.
Adenovirus diseases: a systematic review and meta-analysis of 228 case reports.
复制标题
DOI：
10.1007/s15010-020-01484-7
复制
发表时间：
2021-03
期刊：
影响因子：
7.5
通讯作者：
Chen YB
中科院分区：
文献类型：
--
作者：
Gu J;Su QQ;Zuo TT;Chen YB
各种腺病毒感染的临床特点目前尚不清楚。目的探讨ADV感染的危险因素、临床表现、ADV种类现状、治疗及预后。方法对ADV感染病例进行Pubmed和Embase系统评价，分析ADV感染的临床特征。既往实体器官移植[比值比（OR）= 3.45，95%CI 1.31- 9.08，P = 0.01]，造血干细胞移植（OR = 4.24，95%CI 1.33- 13.51，P = 0.01）（OR = 4.78，95%CI1.70 - 13.46，P = 0.01）与ADV播散性感染的危险性增加有关。使用皮质类固醇（OR = 3.86，95%CI1.21 - 12.24，P = 0.02）是获得性尿路感染的重要危险因素。在100/228例（43.9%）病例中共发现6种（21型）ADV感染。ADV B是最常见的种类。ADV B型（26/60，52.0%或5/41，12.2%P= 0.001）在ADV肺炎患者中更易分离。ADV C（13/15，86.7%vs35/86，40.7%P= 0.001）在播散性疾病患者中检出率更高。在我们的分析中，与角膜结膜炎相关的种属仅为ADV D。在ADV A/B/D种属中观察到尿路ADV感染。西多福韦（CDV）（82/228，36.0%）仍然是我们病例中最常用的抗病毒治疗，其次是利巴韦林（15/228，6.6%），更昔洛韦（18/228，7.9%）和布林西多福韦（12/228，5.3%）。布林西多福韦作为挽救治疗10例。81/228例（35.5%）患者报告死亡。消化道感染（5/10，50.0%）、ADV肺炎（20/45，44.4%）和播散性ADV感染（53/122，43.4%）患者病死率较高。激素的使用对尿路ADV感染有重要意义。不同种属感染的临床表现不同。胃肠道疾病、肺炎和播散性疾病患者的死亡率较高。我们的综述阐明了目前ADV感染的治疗，更多的治疗需要进一步研究。
ObjectiveThe clinical characteristics of various adenovirus (ADV) infection are underexplored up till now. To investigate the risk factors, manifestation, current status of ADV species, treatment and prognosis of this disease.MethodsWe performed a Pubmed and Embase systematic review for case report reporting the ADV infection to analyze the clinical characteristics of disease.ResultsInitial database searched identified articles of which 168 (228 cases) were included in the final analysis. Previous solid organ transplantation [odds ratio (OR) = 3.45, 95% CI 1.31–9.08,P= 0.01], hematopoietic stem cell transplant (OR = 4.24, 95% CI 1.33–13.51,P= 0.01) and hematological malignancy (OR = 4.78, 95% CI 1.70–13.46,P= 0.01) were associated with increased risk of disseminated ADV infection. Use of corticosteroids (OR = 3.86, 95% CI 1.21–12.24,P= 0.02) was a significant risk factor for acquiring urinary tract infections. A total of six species (21 types) of ADV infection have been identified in 100/228 (43.9%) cases. ADV B was the most common species. ADV B species (26/60, 52.0% or 5/41, 12.2%P= 0.001) were more isolated in patients with ADV pneumonia. ADV C (13/15, 86.7% versus 35/86, 40.7%P= 0.001) species were more identified in patients with disseminated disease. The species associated with keratoconjunctivitis is only ADV D in our analysis. Urinary tract ADV infections were observed in ADV A/B/D species. Cidofovir (CDV) (82/228, 36.0%) remained the most commonly antiviral therapy in our cases, followed by ribavirin (15/228, 6.6%), ganciclovir (18/228, 7.9%), and brincidofovir (12/228, 5.3%). Brincidofovir was administered as salvage therapy in 10 cases. Death was reported in 81/228 (35.5%) patients. Mortality rate was higher among patients with gastrointestinal (GI) ADV infection (5/10, 50.0%), ADV pneumonia (20/45, 44.4%) and disseminated ADV infection (53/122, 43.4%).ConclusionPrevious solid organ transplantation, hematopoietic stem cell transplant and hematological malignancy were risk factors for disseminated ADV infection. Use of corticosteroids was significant for urinary tract ADV infection. Different species correlated with different clinical manifestations of infection. Mortality rate was higher among patients with GI disease, pneumonia and disseminated disease. Our review clarified the current treatment of ADV infections, and more treatment required further investigation.
登录
查看更多内容
影响因子：
3.6
作者：
Averbuch, Diana;Safadi, Rifaat;Amit, Sharon
通讯作者：
Amit, Sharon
影响因子：
3.6
作者：
Bhatti, Zabeer;Dhamoon, Amit
通讯作者：
Dhamoon, Amit
影响因子：
4.2
作者：
Cederwall, S.;Pahlman, L., I
通讯作者：
Pahlman, L., I
DOI：
10.1093/ndtplus/sfq024
发表时间：
2010-08
期刊：
NDT plus
影响因子：
--
作者：
Kolankiewicz LM;Pullman J;Raffeld M;Kopp JB;Glicklich D
通讯作者：
Glicklich D
影响因子：
2.6
作者：
Bruminhent, J.;Athas, D. M.;Flomenberg, P.
通讯作者：
Flomenberg, P.