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Meta-Analysis
. 2023 Jan;11(1):e760.
doi: 10.1002/iid3.760.

Analysis of risk factors of fungal superinfections in viral pneumonia patients: A systematic review and meta-analysis

Haiyang Ni  1 , Hongying Yu  1 , Qibin Lin  1 , Jieying Zhong  1 , Wenjin Sun  2 , Hanxiang Nie  1
Affiliations
Meta-Analysis

Analysis of risk factors of fungal superinfections in viral pneumonia patients: A systematic review and meta-analysis

Haiyang Ni et al. Immun Inflamm Dis. 2023 Jan.

Abstract

Background: Infections with fungi, such as Aspergillus species, have been found as common complications of viral pneumonia. This study aims to determine the risk factors of fungal superinfections in viral pneumonia patients using meta-analysis.

Objective: This study aims to determine the risk factors of fungal infection s in viral pneumonia patients using meta-analysis.

Methods: We reviewed primary literature about fungal infection in viral pneumonia patients published between January 1, 2010 and September 30, 2020, in the Chinese Biomedical Literature, Chinese National Knowledge Infrastructure, Wanfang (China), Cochrane Central Library, Embase, PubMed, and Web of Science databases. These studies were subjected to an array of statistical analyses, including risk of bias and sensitivity analyses.

Results: In this study, we found a statistically significant difference in the incidence of fungal infections in viral pneumonia patients that received corticosteroid treatment as compared to those without corticosteroid treatment (p < .00001). Additionally, regarding the severity of fungal infections, we observed significant higher incidence of invasive pulmonary aspergillosis (IPA) in patients with high Acute Physiology and Chronic Health Evaluation (APACHE) II scores (p < .001), tumors (p = .005), or immunocompromised patients (p < .0001).

Conclusions: Our research shows that corticosteroid treatment was an important risk factor for the development of fungal infection in patients with viral pneumonia. High APACHE II scores, tumors, and immunocompromised condition are also important risk factors of developing IPA. The diagnosis of fungal infection in viral pneumonia patients can be facilitated by early serum galactomannan (GM) testing, bronchoalveolar lavage fluid Aspergillus antigen testing, culture, and biopsy.

Keywords: IPA; corticosteroid; fungal infection; systematic review and meta-analysis; viral pneumonia.

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Figures

Figure 1
Figure 1
Flow chart
Figure 2
Figure 2
Forest plot of risk of fungus infection during corticosteroid treatment for viral pneumonia
Figure 3
Figure 3
Subgroup analysis forest plot of risk of fungus infection during corticosteroid treatment for viral pneumonia
Figure 4
Figure 4
Forest plot of risk of aspergillus infection during corticosteroid treatment for viral pneumonia
See this image and copyright information in PMC

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