Clinical characteristics and severity of influenza infections by virus type, subtype, and lineage: A systematic literature review.
Clinical characteristics and severity of influenza infections by virus type, subtype, and lineage: A systematic literature review.
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DOI：
10.1111/irv.12575
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发表时间：
2018-11
影响因子：
4.4
通讯作者：
Paget J
中科院分区：
文献类型：
--
作者：
Caini S;Kroneman M;Wiegers T;El Guerche-Séblain C;Paget J
21世纪初进行的研究发现，流感相关住院和死亡人数在甲型H3N2流感占主导地位的季节最高，这表明流感的临床表现和严重程度可能因病毒类型、亚型和谱系而异。我们的目的是审查研究，检查这一假设。我们对截至2017年1月发表的研究进行了文献综述，这些研究比较了感染不同病毒类型（A、B）、亚型（大流行前A（H1N1）、A（H1N1）p、A（H3N2））和谱系（维多利亚、山形）的流感患者的临床表现、疾病严重程度和病死率。文献检索得到1700多个条目：应用入选和排除标准后，文献综述中纳入了47项研究。研究表明，在环境和人口的广泛多样性。只有少数研究提供了根据患者年龄和其他潜在混杂因素调整的结果。感染不同流感病毒的患者的临床表现差异很小。我们发现弱证据表明，大流行后时期A（H1N1）p亚型比其他流感病毒（亚型）类型更容易与继发性细菌性肺炎、ICU入院和死亡相关。与通常的假设相反，致病病毒亚型似乎不是流感疾病临床表现和严重程度的主要决定因素。然而，由于纳入研究的可比性低和方法学缺陷，很难得出结论，需要更多设计良好的研究。
Studies carried out in the early 2000s found that the number of influenza‐associated hospitalizations and deaths was highest in seasons dominated by A(H3N2), suggesting that the clinical presentation and severity of influenza may differ across virus types, subtypes, and lineages. We aimed to review the studies that examined this hypothesis. We conducted a literature review of studies published until January 2017 that compared the clinical presentation, disease severity, and case‐fatality ratio of influenza patients infected with different virus types (A, B), subtypes (pre‐pandemic A(H1N1), A(H1N1)p, A(H3N2)), and lineages (Victoria, Yamagata). The literature search resulted in over 1700 entries: After applying in‐ and exclusion criteria, 47 studies were included in the literature review. Studies showed a wide diversity in setting and populations. Only a minority of studies provided results adjusted by patient's age and other potential confounders. There were very few differences in the clinical presentation of patients infected with different influenza viruses. We found weak evidence that the A(H1N1)p subtype in the post‐pandemic period was more often associated with secondary bacterial pneumonia, ICU admission, and death, than the other influenza virus (sub)types. Contrary to what is commonly assumed, the causal virus subtype does not seem to be a major determinant of clinical presentation and severity of influenza illness. However, drawing conclusions was made difficult by the low comparability and methodological shortcomings of included studies, and more well‐designed studies are warranted.
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影响因子：
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