SARS-CoV-2与流感病毒合并感染对患者预后影响meta分析

Impact of influenza virus co-infection on prognosis of patients with SARS-CoV-2 infection:a meta-analysis

目的探讨新型冠状病毒(SARS-CoV-2)与流感病毒合并感染对患者预后的影响,为合并感染的防治提供科学依据。方法检索Web of Science、PubMed、Scopus、Embase、the Cochrane Library和中国知网数据库,并辅以文献追溯法收集2020年1月1日—2023年5月31日国内外公开发表的SARS-CoV-2患者合并流感与严重疾病结局的相关文献;应用R 4.2.1软件对纳入的文献进行meta分析。结果最终纳入24篇英文文献,共计26610例患者,其中仅感染SARS-CoV-2患者20625例,仅感染流感患者3806例,合并感染患者2179例;对其中4篇文献中流感病毒合并感染与仅流感病毒感染患者严重疾病结局比较的meta分析结果显示,合并感染患者入住重症加强护理病房、机械通气支持、死亡的风险分别为仅感染流感患者的2.13倍(OR=2.13,95%CI=1.15~3.94)、5.02倍(OR=5.02,95%CI=2.38~10.59)和4.84倍(OR=4.84,95%CI=2.21~10.61);敏感性分析和发表偏倚检验结果显示,本次meta分析纳入的文献不存在发表偏倚,结果较为稳定。结论合并感染可能会导致流感病毒感染患者更严重疾病结局的发生,对其预后造成一定影响。

Objective To explore the impact of influenza virus co-infection on prognosis of patients with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods We retrieved studies relevant to outcomes of patients with mono-/co-infection of SARS-CoV-2/influenza viruses published from January 2020 through May 2023 through searching Web of Science,PubMed,Scopus,Embase,the Cochrane Library,and China National Knowledge Infrastructure and with supplementation of literature tracing.R 4.2.1 statistical software was used to perform metaanalysis.Results Totally 24 English articles were included in the analysis,which involved 26610 patients(20625 SARS-CoV-2 mono-infections,3806 mono-influenza virus infections,and 2179 co-infections of SARS-CoV-2 and influenza virus).The results of meta-analysis showed that the patients with co-infection of SARS-CoV-2 and influenza virus were at increased risk of admission to intensive care unit(odds ratio[OR]=2.13,95%confidence interval[95%CI]:1.15–3.94),having mechanical ventilation support(OR=5.02,95%CI:2.38–10.59),and mortality(OR=4.84,95%CI:2.21–10.61)compared to the patients with mono-influenza virus infection.No publication bias was observed and the analysis results were relatively stable based on publication bias test and sensitivity analysis on the included literatures.Conclusion The co-infection of SARS-CoV-2 and influenza virus may result in severe outcomes and affect the prognosis of the patients with the co-infection.