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Meta-Analysis
. 2023 May;33(3):e2437.
doi: 10.1002/rmv.2437. Epub 2023 Mar 7.

Reactivation of herpesviruses during COVID-19: A systematic review and meta-analysis

Arman Shafiee  1   2 , Mohammad Mobin Teymouri Athar  3 , Mohammad Javad Amini  2 , Hamed Hajishah  4 , Sepehr Siahvoshi  5 , Mehrsa Jalali  2 , Bahar Jahanbakhshi  2 , Sayed-Hamidreza Mozhgani  6   7
Affiliations
Meta-Analysis

Reactivation of herpesviruses during COVID-19: A systematic review and meta-analysis

Arman Shafiee et al. Rev Med Virol. 2023 May.

Abstract

To provide a comprehensive systematic review and meta-analysis regarding the cumulative incidence (incidence proportion) of human herpesvirus (HHV) reactivation among patients with coronavirus disease 2019 (COVID-19), we searched PubMed/MEDLINE, Web of Science, and EMBASE up to 25 September 2022, with no language restrictions. All interventional and observational studies enrolling patients with confirmed COVID-19 and providing data regarding HHV reactivation were included. The random-effects model was used in the meta-analyses. We included information from 32 studies. HHV reactivation was considered a positive polymerase chain reaction result taken at the time of COVID-19 infection. Most of the included patients were severe COVID-19 cases. The pooled cumulative incidence estimate was 38% (95% Confidence Intervals [CI], 28%-50%, I2 = 86%) for herpes simplex virus (HSV), 19% (95% CI, 13%-28%, I2 = 87%) for cytomegalovirus (CMV), 45% (95% CI, 28%-63%, I2 = 96%) for Epstein-Barr virus (EBV), 18% (95% CI, 8%-35%) for human herpesvirus 6 (HHV-6), 44% (95% CI, 32%-56%) for human herpesvirus 7 (HHV-7), and 19% (95% CI, 14%-26%) for human herpesvirus 8 (HHV-8). There was no evidence of funnel plot asymmetry based on visual inspection and Egger's regression test for the results of HSV (p = 0.84), CMV (p = 0.82), and EBV (p = 0.27) reactivation. In conclusion, the identification of HHV reactivation in severe COVID-19 patients is helpful in the management of patients as well as the prevention of complications. Further research is required to elucidate the interaction between HHVs and COVID-19. Systematic review registration: PROSPERO CRD42022321973.

Keywords: COVID-19; SARS-CoV-2; human herpesviruses.

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References

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