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The etiological role of common respiratory viruses in acute respiratory infections in older adults: a systematic review and meta-analysis

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Title: The etiological role of common respiratory viruses in acute respiratory infections in older adults: a systematic review and meta-analysis
Authors: Shi, T
Arnott, A
Semogas, I
Falsey, AR
Openshaw, P
Wedzicha, JA
Campbell, H
Nair, H
RESCEU Investigators
Item Type: Journal Article
Abstract: Acute respiratory tract infections (ARI) constitute a substantial disease burden in adults and elderly individuals. We aimed to identify all case-control studies investigating the potential role of respiratory viruses in the etiology of ARI in older adults aged ≥65 years. We conducted a systematic literature review (across 7 databases) of case-control studies published from 1996 to 2017 that investigated the viral profile of older adults with and those without ARI. We then computed a pooled odds ratio (OR) with a 95% confidence interval and virus-specific attributable fraction among the exposed (AFE) for 8 common viruses: respiratory syncytial virus (RSV), influenza virus (Flu), parainfluenza virus (PIV), human metapneumovirus (HMPV), adenovirus (AdV), rhinovirus (RV), bocavirus (BoV), and coronavirus (CoV). From the 16 studies included, there was strong evidence of possible causal attribution for RSV (OR, 8.5 [95% CI, 3.9-18.5]; AFE, 88%), Flu (OR, 8.3 [95% CI, 4.4-15.9]; AFE, 88%), PIV (OR, not available; AFE, approximately 100%), HMPV (OR, 9.8 [95% CI, 2.3-41.0]; AFE, 90%), AdV (OR, not available; AFE, approximately 100%), RV (OR, 7.1 [95% CI, 3.7-13.6]; AFE, 86%) and CoV (OR, 2.8 [95% CI, 2.0-4.1]; AFE, 65%) in older adults presenting with ARI, compared with those without respiratory symptoms (ie, asymptomatic individuals) or healthy older adults. However, there was no significant difference in the detection of BoV in cases and controls. This review supports RSV, Flu, PIV, HMPV, AdV, RV, and CoV as important causes of ARI in older adults and provides quantitative estimates of the absolute proportion of virus-associated ARI cases to which a viral cause can be attributed. Disease burden estimates should take into account the appropriate AFE estimates (for older adults) that we report.
Issue Date: 8-Mar-2019
Date of Acceptance: 6-Dec-2018
URI: http://hdl.handle.net/10044/1/67864
DOI: https://dx.doi.org/10.1093/infdis/jiy662
ISSN: 0022-1899
Publisher: Oxford University Press (OUP)
Journal / Book Title: Journal of Infectious Diseases
Copyright Statement: © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Etiological role
acute respiratory infection
older adults
respiratory virus
RESCEU Investigators
11 Medical And Health Sciences
06 Biological Sciences
Microbiology
Publication Status: Published online
Conference Place: United States
Online Publication Date: 2019-03-08
Appears in Collections:National Heart and Lung Institute
Airway Disease



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