Halsby Kate, Gildea Liesl, Zhang Pingping, Angulo Frederick J, Pilz Andreas, Moisi Jennifer, Colosia Ann, Sellner Johann
Global Vaccines and Anti-Infectives Medical Affairs, Pfizer, Surrey, United Kingdom.
Value and Access, RTI Health Solutions, Manchester, United Kingdom.
Open Forum Infect Dis. 2025 May 29;12(6):ofaf317. doi: 10.1093/ofid/ofaf317. eCollection 2025 Jun.
Infection with the tick-borne encephalitis virus (TBEV) can affect the nervous system and lead to significant morbidity. To summarize current knowledge of long-term outcomes following TBEV infection, we systematically reviewed the prevalence of TBEV infection sequelae after hospital discharge across different age groups and follow-up time points.
Studies of adults, children, and "all-age" populations with laboratory-confirmed TBEV infection were identified via electronic database searches. Study categorization was based on follow-up time after hospital discharge: ≤6, 7 to ≤12, or >12 months. Sequelae signs/symptoms were divided into 3 categories: neurological, neuropsychiatric, and other. Data were normalized using weighted means. Heterogeneity was estimated using a meta-analytic random-effects model.
Fifteen studies were eligible for analysis (13 included only hospitalized patients). Seventy-nine unique sequelae symptoms were identified. Adults had a higher frequency of persistent symptoms than children (20.6%-100% vs 1.7%-69%). There were high levels of data heterogeneity ( > 90%) among all studies. Although the proportion of patients with each sequela fluctuated across time, headache was reported by ≥20% of patients at all time points. Some sequelae also varied by age group; for example, irritability was more frequent in children, while insomnia/sleep disorders were more frequent in adults. Predominant neurological symptoms included balance disorders and headache. Predominant neuropsychiatric symptoms included concentration and memory disorders.
Patients experience a variety of neurological, neuropsychiatric, or other sequelae symptoms following TBEV infection that vary over time and across age groups. This study highlights the need for standardized symptom categorization and follow-up time for TBE sequelae studies.
蜱传脑炎病毒（TBEV）感染可影响神经系统并导致严重发病。为总结TBEV感染后长期预后的现有知识，我们系统回顾了不同年龄组和随访时间点出院后TBEV感染后遗症的患病率。
通过电子数据库检索确定对成人、儿童和“所有年龄”人群进行的实验室确诊TBEV感染研究。研究分类基于出院后的随访时间：≤6个月、7至≤12个月或>12个月。后遗症体征/症状分为3类：神经、神经精神和其他。数据采用加权均值进行标准化。使用荟萃分析随机效应模型估计异质性。
15项研究符合分析条件（13项仅纳入住院患者）。共识别出79种独特的后遗症症状。成人持续症状的发生率高于儿童（20.6%-100%对1.7%-69%）。所有研究之间的数据异质性水平较高（>90%）。尽管每种后遗症患者的比例随时间波动，但在所有时间点均有≥20%的患者报告头痛。一些后遗症也因年龄组而异；例如易激惹在儿童中更常见，而失眠/睡眠障碍在成人中更常见。主要的神经症状包括平衡障碍和头痛；主要的神经精神症状包括注意力和记忆障碍。
TBEV感染后患者会出现各种神经、神经精神或其他后遗症症状，这些症状随时间和年龄组而有所不同。本研究强调了TBE后遗症研究中标准化症状分类和随访时间的必要性。
