Riccò Matteo, Corrado Silvia, Palmieri Sara, Marchesi Federico
Local Health Unit of Reggio Emilia, Servizio di Prevenzione e Sicurezza Negli Ambienti di Lavoro (SPSAL), AUSL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy.
UOC Pediatria, Dipartimento della Donna e Area Materno-Infantile, ASST Rhodense, 20024 Garbagnate Milanese, Italy.
Children (Basel). 2023 Jul 5;10(7):1169. doi: 10.3390/children10071169.
Human respiratory syncytial virus (RSV) is a main cause of medical referrals and hospitalizations in all infants, particularly among newborns. Nevertheless, relatively limited evidence on chest tomography (CT) findings has been collected. According to the PRISMA statement, Pubmed, Embase, and medRxiv were searched for eligible observational studies published up to 31 December 2022. Cases were categorized in children and adolescents (age < 18 years), adults and elderly (age ≥ 18 years), and immunocompromised patients, and then pooled in a random-effects model. Heterogeneity was assessed using the I2 statistics, while reporting bias was assessed by means of funnel plots and regression analysis. A total of 10 studies (217 RSV cases) were retrieved (children, 37.3%; immunocompromised, 41.0%; adults, 21.7%). The most common features were signs of organizing pneumonia (33.65%, 95% confidence interval [95% CI] 22.39-47.27), followed by septal thickening (33.19%, 95% CI 21.76-47.03), ground glass opacities (GGOs; 28.03%, 95% CI 14.69-46.82), and tree-in-bud (TIB, 27.44%, 95% CI 15.04-44.68). Interestingly, up to 16.23% (95% CI 8.17-29.69) showed normal findings, while the large majority (76.06%, 95% CI 64.81-84.56) were characterized by bilateral involvement. Studies were highly heterogeneous without substantial reporting bias. Assuming children and adolescents as reference groups, healthy adults were characterized by a higher risk ratio [RR] for septal thickening (RR 3.878, 95% CI 1.253-12.000), nodular lesions (RR 20.197, 95% CI 1.286-317.082), and GGOs (RR 2.121, 95% CI 1.121-4.013). RSV cases are rarely assessed in terms of CT characteristics. Our study identified some specificities, suggesting that RSV infections evolve heterogeneous CT features in children/adolescents and adults, but the paucity of studies recommends a cautious appraisal.
人类呼吸道合胞病毒（RSV）是所有婴儿，尤其是新生儿医疗转诊和住院的主要原因。然而，关于胸部断层扫描（CT）结果的证据相对有限。根据PRISMA声明，检索了Pubmed、Embase和medRxiv中截至2022年12月31日发表的符合条件的观察性研究。病例分为儿童和青少年（年龄<18岁）、成人和老年人（年龄≥18岁）以及免疫功能低下患者，然后纳入随机效应模型进行汇总分析。使用I²统计量评估异质性，通过漏斗图和回归分析评估报告偏倚。共检索到10项研究（217例RSV病例）（儿童占37.3%；免疫功能低下患者占41.0%；成人占21.7%）。最常见的特征是机化性肺炎的表现（33.65%，95%置信区间[95%CI]22.39 - 47.27），其次是间隔增厚（33.19%，95%CI 21.76 - 47.03）、磨玻璃影（GGOs；28.03%，95%CI 14.69 - 46.82）和树芽征（TIB，27.44%，95%CI 15.04 - 44.68）。有趣的是，高达16.23%（95%CI 8.17 - 29.69）的病例表现正常，而绝大多数（76.06%，95%CI 64.81 - 84.56）以双侧受累为特征。研究具有高度异质性，但无明显报告偏倚。以儿童和青少年作为参照组，健康成人出现间隔增厚（风险比[RR]3.878，95%CI 1.253 - 12.000）、结节状病变（RR 20.197，95%CI 1.286 - 317.082）和磨玻璃影（RR 2.121，95%CI 1.121 - 4.013）的风险更高。RSV病例很少根据CT特征进行评估。我们的研究确定了一些特异性表现，提示RSV感染在儿童/青少年和成人中呈现出异质性的CT特征，但研究数量有限，建议谨慎评估。
