Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Science/National Research Foundation: Vaccine-Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Pediatr Pulmonol. 2020 Jul;55(7):1567-1583. doi: 10.1002/ppul.24804. Epub 2020 May 4.
Respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) during early childhood may be associated with subsequent pulmonary sequelae, including recurrent wheezing and asthma. We undertook a systematic review to investigate the pulmonary function sequelae following RSV LRTI in the first 3 years of life. The systematic review protocol was registered on PROSPERO (CRD42018087168). PubMed, Scopus, Cochrane Library, and World Health Organization Global Index Medicus, as well as ClinicalTrials.gov and Cochrane Central Register of Controlled Trials, were searched up until 15 June 2019 for published and unpublished interventional and observational studies with the end-point outcome of pulmonary function testing (PFT) after a proven RSV LRTI in the first 3 years of life. Two independent reviewers screened all the titles, abstracts and full texts. Data were extracted using a standardized data extraction form. Corresponding authors were contacted for additional information if required. All studies were assessed for risk of bias using the Newcastle-Ottawa quality assessment scale. The final analysis included 31 studies. Thirteen studies using spirometry reported no association between RSV LRTI and pulmonary function sequelae. The remaining 16 reported abnormal spirometry; 12 obstructive airways disease, three restrictive lung disease, and one mixed lung disease. The heterogeneity in PFT techniques, different ages at testing, and methods used for reporting outcomes made direct comparisons or pooled effect estimates impossible. Children with confirmed RSV LRTI during the first 3 years of life often have abnormal PFTs, favoring obstructive airways disease. The evidence, however, is not overwhelming with conflicting results between studies.
呼吸道合胞病毒（RSV）下呼吸道感染（LRTI）在幼儿期可能与随后的肺部后遗症有关，包括反复喘息和哮喘。我们进行了一项系统评价，以调查生命前 3 年 RSV LRTI 后肺功能的后遗症。系统评价方案已在 PROSPERO（CRD42018087168）上注册。截至 2019 年 6 月 15 日，我们在 PubMed、Scopus、Cochrane 图书馆、世界卫生组织全球医学索引以及 ClinicalTrials.gov 和 Cochrane 对照试验中心注册库中搜索了已发表和未发表的干预和观察性研究，这些研究的终点结局是生命前 3 年内证实 RSV LRTI 后的肺功能测试（PFT）。两名独立评审员筛选了所有标题、摘要和全文。使用标准化的数据提取表提取数据。如果需要，联系相应的作者以获取更多信息。使用纽卡斯尔-渥太华质量评估量表评估所有研究的偏倚风险。最终分析包括 31 项研究。13 项使用肺活量计的研究报告 RSV LRTI 与肺功能后遗症之间无关联。其余 16 项报告了异常肺活量计；12 项阻塞性气道疾病，3 项限制性肺疾病，1 项混合性肺疾病。PFT 技术、测试时的不同年龄以及用于报告结果的方法的异质性使得无法进行直接比较或汇总效应估计。在生命前 3 年内确诊 RSV LRTI 的儿童通常 PFT 异常，有利于阻塞性气道疾病。然而，证据并不确凿，研究之间存在相互矛盾的结果。
