Prevalence of viral infection detected by PCR and RT-PCR in patients with acute exacerbation of COPD: A systematic review

被引:145
作者
Mohan, Anant [1 ]
Chandra, Subhash [2 ]
Agarwal, Dipti [2 ]
Guleria, Randeep
Broor, Shobha
Gaur, Bharti
Pandey, Ravindra Mohan
机构
[1] All India Inst Med Sci, Dept Med, New Delhi 110029, India
[2] Mayo Clin, Dept Med, Rochester, NY USA
关键词
chronic obstructive pulmonary disease; polymerase chain reaction; respiratory virus; OBSTRUCTIVE PULMONARY-DISEASE; RESPIRATORY VIRUSES; INFLUENZA VACCINATION; HOSPITALIZATION; ETIOLOGY;
D O I
10.1111/j.1440-1843.2010.01722.x
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background and objective: Viruses are important aetiological agents of acute exacerbation of COPD (AECOPD). Their reported prevalence varies from region to region. This systematic review calculated the prevalence of respiratory viral infections in AECOPD. Methods: A systematic search was performed using Medline, and references of relevant articles and conference proceedings were hand searched. Articles for review were selected based on the following criteria: (i) prospective or cross-sectional study, (ii) original research, (iii) viral detection used the highly sensitive techniques of PCR and/or Reverse Transcriptase PCR (RT-PCR), (iv) viral prevalence in AECOPD defined, and (v) full paper available in English. We assessed the study quality and extracted data independently and in duplicate using a pre-defined data extraction form. Weighted mean prevalence (WMP) was calculated and a forest plot was constructed to show the dispersion. Results: Eight studies met the inclusion criteria. The WMP of respiratory viral infection in AECOPD was 34.1% (95% CI: 23.9-44.4). picornavirus was the most commonly detected virus with WMP 17.3% (95% CI: 7.2-27.3), followed by influenza; 7.4% (95% CI: 2.9-12.0), respiratory syncytial virus; 5.3% (95% CI: 1.6-9.0), corona viruses; 3.1% (95% CI: 0.4-5.8), parainfluenza; 2.6% (95% CI: 0.4-4.8), adenovirus; 1.1% (95% CI: -1.1 to 3.3), and human metapneumovirus; 0.7% (95% CI: -0.3 to 1.8). Maximum WMP was observed in studies from Europe followed by the USA, Australia and Asia. Picorna was the most common virus detected in Western countries whereas influenza was most common in Asia. Conclusions: This systematic review demonstrated that viruses are strongly associated with AECOPD, with the highest detection rates of viruses being in Europe. The geographical epidemiology of viruses may have important therapeutic implications for management of AECOPD.
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页码:536 / 542
页数:7
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