Nealon Joshua, Derqui Nieves, de Courville Caroline, Biering-Sørensen Tor, Cowling Benjamin J, Nair Harish, Chaves Sandra S
Sanofi, Lyon, France.
Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.
Open Forum Infect Dis. 2022 Jul 21;9(8):ofac352. doi: 10.1093/ofid/ofac352. eCollection 2022 Aug.
We conducted a scoping review of the epidemiological literature from the past 50 years to document the contribution of influenza virus infection to extrapulmonary clinical outcomes. We identified 99 publications reporting 243 associations using many study designs, exposure and outcome definitions, and methods. Laboratory confirmation of influenza was used in only 28 (12%) estimates, mostly in case-control and self-controlled case series study designs. We identified 50 individual clinical conditions associated with influenza. The most numerous estimates were of cardiocirculatory diseases, neurological/neuromuscular diseases, and fetal/newborn disorders, with myocardial infarction the most common individual outcome. Due to heterogeneity, we could not generate summary estimates of effect size, but of 130 relative effect estimates, 105 (81%) indicated an elevated risk of extrapulmonary outcome with influenza exposure. The literature is indicative of systemic complications of influenza virus infection, the requirement for more effective influenza control, and a need for robust confirmatory studies.
我们对过去50年的流行病学文献进行了一项范围综述，以记录流感病毒感染对肺外临床结局的影响。我们通过多种研究设计、暴露和结局定义以及方法，确定了99篇报告243种关联的出版物。仅在28项（12%）评估中使用了流感的实验室确诊，大多用于病例对照研究和自我对照病例系列研究设计。我们确定了50种与流感相关的个体临床病症。估计数量最多的是心血管疾病、神经/神经肌肉疾病以及胎儿/新生儿疾病，其中心肌梗死是最常见的个体结局。由于存在异质性，我们无法得出效应大小的汇总估计值，但在130项相对效应估计中，105项（81%）表明流感暴露会增加肺外结局的风险。该文献表明了流感病毒感染的全身并发症、对更有效流感防控的需求以及开展有力确证性研究的必要性。
