Analysis of risk factors of fungal superinfections in viral pneumonia patients: A systematic review and meta‐analysis. Issue 1 (31st December 2022)

• Record Type: Journal Article
• Authors: Ni, Haiyang; Yu, Hongying; Lin, Qibin; Zhong, Jieying; Sun, Wenjin; Nie, Hanxiang
• Is Part Of: Immunity, inflammation and disease. Volume 11:Issue 1(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-12-31
• Subjects: corticosteroid -- fungal infection -- IPA -- systematic review and meta‐analysis -- viral pneumonia; Immunology -- Periodicals; Immunity -- Periodicals; Inflammation -- Periodicals; 616.079
• DOI: 10.1002/iid3.760
• Languages: English
• ISSNs: 2050-4527

Abstract

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. Abstract : Viruses are common pathogens of respiratory infections that can lead to severe morbidity and mortality. Viral pneumonia can be caused by virus invading human body. Infection with fungal pathogens has been shown as complications of viral pneumonia. Our research shows that corticosteroid treatment was an important risk of fungal infection, especially invasive pulmonary aspergillosis (IPA), in viral pneumonia patients. High Acute Physiology and Chronic Health Evaluation II scores, tumors, and immunocompromised condition, were also important risk factors of IPA inn viral pneumonia patients. We recommend that early testing for IPA, such as early serum galactomannan testing, bronchoalveolar lavage fluid Aspergillus antigen testing, culture, or biopsy should be prescribed to these patients to reduce potential mortality rate.