The effect of influenza virus infection on pregnancy outcomes: A systematic review and meta-analysis of cohort studies

ABSTRACTObjectivesFatigue is a pervasive clinical symptom for many infected with respiratory viruses such as influenza or coronaviruses. Prior evidence from influenza and coronavirus epidemics suggest that fatigue symptomology may continue beyond the acute phase, lasting for several months to several years post-discharge. This systematic review aimed to examine long-term fatigue prevalence among survivors and among communities, as well as investigate the current evidence for associated factors.DesignSystematic review and meta-analysis.SettingHospitalised and community samples.ParticipantsPatient populations with a confirmed diagnosis of a named influenza virus or coronavirus.Main outcomes measuredFatigue, fatigue syndromesResultsTen studies met the inclusion criteria for a pooled prevalence analysis and five studies were identified as eligible for a means differences analysis. A fatigue prevalence of 41% (95% CI 0.299-0.488) was found among a total population of 1,310. Using the ‘vitality’ subscale of the SF-36 as a proxy for fatigue, the estimate for means differences indicated a lower mean vitality score for survivors compared to population norms (M -1.523, CI -13.53 – 10.48), although this was not significant (p = 0.803). The most common associations with fatigue were PTSD, depression and anxiety, female gender and higher age.ConclusionsThis study reveals that a significant proportion of survivors (41%) experienced fatigue following their recovery from novel respiratory viruses such as SARS, MERS, SARS-CoV2 or influenza and that this fatigue can be long-lasting. Also, some factors such as female gender and psychological factors may contribute to continuing fatigue outcomes for this population.Strengths and limitations(a) this study provides support for long-term fatigue outcomes in people with a confirmed influenza, SARS, MERS, SARS-CoV2 virus infection (b) the study suggests individual, psychological and social factors are associated with fatigue, (c) findings are limited by the availability of fatigue data and lack of pre-morbid fatigue information; (d) a meta-analysis on the associations was prohibited by the small number of studies investigating long-term fatigue correlates and (e) the heterogeneity of the studies (>75%) suggests the pooled estimates should be interpreted with caution.

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Efficacy and safety of baloxavir marboxil versus neuraminidase inhibitors in the treatment of influenza virus infection in high-risk and uncomplicated patients – a Bayesian network meta-analysis

Current Medical Research and Opinion ◽

10.1080/03007995.2020.1839400 ◽

2020 ◽

pp. 1-20

Author(s):

Vanessa Taieb ◽

Hidetoshi Ikeoka ◽

Piotr Wojciechowski ◽

Katarzyna Jablonska ◽

Samuel Aballea ◽

...

Keyword(s):

Influenza Virus ◽

High Risk ◽

Virus Infection ◽

Bayesian Network ◽

Meta Analysis ◽

Influenza Virus Infection ◽

Neuraminidase Inhibitors ◽

Efficacy And Safety

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H1N1 influenza virus infection results in adverse pregnancy outcomes by disrupting tissue-specific hormonal regulation

PLoS Pathogens ◽

10.1371/journal.ppat.1006757 ◽

2017 ◽

Vol 13 (11) ◽

pp. e1006757 ◽

Cited By ~ 32

Author(s):

Elizabeth Q. Littauer ◽

E. Stein Esser ◽

Olivia Q. Antao ◽

Elena V. Vassilieva ◽

Richard W. Compans ◽

...

Keyword(s):

Influenza Virus ◽

Virus Infection ◽

Pregnancy Outcomes ◽

Hormonal Regulation ◽

Influenza Virus Infection ◽

H1n1 Influenza ◽

Adverse Pregnancy Outcomes ◽

H1n1 Influenza Virus ◽

Tissue Specific ◽

Adverse Pregnancy

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Comparative fertility and pregnancy outcomes after local treatment for cervical intraepithelial neoplasia and stage 1a1 cervical cancer: protocol for a systematic review and network meta-analysis from the CIRCLE group

BMJ Open ◽

10.1136/bmjopen-2018-028009 ◽

2019 ◽

Vol 9 (10) ◽

pp. e028009 ◽

Cited By ~ 2

Author(s):

Antonios Athanasiou ◽

Areti Angeliki Veroniki ◽

Orestis Efthimiou ◽

Ilkka Kalliala ◽

Huseyin Naci ◽

...

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Cervical Intraepithelial Neoplasia ◽

Pregnancy Outcomes ◽

Primary Outcome ◽

Meta Analysis ◽

Local Treatment ◽

Intraepithelial Neoplasia ◽

Risk Of Bias ◽

Treatment Comparison

IntroductionThere are several local treatment methods for cervical intraepithelial neoplasia that remove or ablate a cone-shaped part of the uterine cervix. There is evidence to suggest that these increase the risk of preterm birth (PTB) and that this is higher for techniques that remove larger parts of the cervix, although the data are conflicting. We present a protocol for a systematic review and network meta-analysis (NMA) that will update the evidence and compare all treatments in terms of fertility and pregnancy complications.Methods and analysisWe will search electronic databases (CENTRAL, MEDLINE, EMBASE) from inception till October 2019, in order to identify randomised controlled trials (RCTs) and cohort studies comparing the fertility and pregnancy outcomes among different excisional and ablative treatment techniques and/or to untreated controls. The primary outcome will be PTB (<37 weeks). Secondary outcomes will include severe or extreme PTB, prelabour rupture of membranes, low birth weight (<2500 g), neonatal intensive care unit admission, perinatal mortality, total pregnancy rates, first and second trimester miscarriage. We will search for published and unpublished studies in electronic databases, trial registries and we will hand-search references of published papers. We will assess the risk of bias in RCTs and cohort studies using tools developed by the Cochrane collaboration. Two investigators will independently assess the eligibility, abstract the data and assess the risk of bias of the identified studies. For each outcome, we will perform a meta-analysis for each treatment comparison and an NMA once the transitivity assumption holds, using the OR for dichotomous data. We will use CINeMA (Confidence in Network meta-analysis) to assess the quality of the evidence for the primary outcome.Ethics and disseminationEthical approval is not required. Results will be disseminated to academic beneficiaries, medical practitioners, patients and the public.PROSPERO registration numberCRD42018115495

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Possible Roles of Proinflammatory and Chemoattractive Cytokines Produced by Human Fetal Membrane Cells in the Pathology of Adverse Pregnancy Outcomes Associated with Influenza Virus Infection

Mediators of Inflammation ◽

10.1155/2012/270670 ◽

2012 ◽

Vol 2012 ◽

pp. 1-32 ◽

Cited By ~ 34

Author(s):

Noboru Uchide ◽

Kunio Ohyama ◽

Toshio Bessho ◽

Makoto Takeichi ◽

Hiroo Toyoda

Keyword(s):

Influenza Virus ◽

Virus Infection ◽

Proinflammatory Cytokines ◽

Pregnancy Outcomes ◽

Influenza Virus Infection ◽

Adverse Pregnancy Outcomes ◽

Fetal Membrane ◽

Premature Delivery ◽

Fetal Membranes ◽

Adverse Pregnancy

Pregnant women are at an increased risk of influenza-associated adverse outcomes, such as premature delivery, based on data from the latest pandemic with a novel influenza A (H1N1) virus in 2009-2010. It has been suggested that the transplacental transmission of influenza viruses is rarely detected in humans. A series of our study has demonstrated that influenza virus infection induced apoptosis in primary cultured human fetal membrane chorion cells, from which a factor with monocyte differentiation-inducing (MDI) activity was secreted. Proinflammatory cytokines, such as interleukin (IL)-6, tumor necrosis factor (TNF)-α, and interferon (IFN)-β, were identified as a member of the MDI factor. Influenza virus infection induced the mRNA expression of not only the proinflammatory cytokines but also chemoattractive cytokines, such as monocyte chemoattractant protein (MCP)-1, regulated on activation, normal T-cell expressed and secreted (RANTES), macrophage inflammatory protein (MIP)-1β, IL-8, growth-regulated oncogene (GRO)-α, GRO-β, epithelial cell-derived neutrophil-activating protein (ENA)-78, and interferon inducible protein (IP)-10 in cultured chorion cells. These cytokines are postulated to associate with human parturition. This paper, therefore, reviews (1) lessons from pandemic H1N1 2009 in pregnancy, (2) production of proinflammatory and chemoattractive cytokines by human fetal membranes and their functions in gestational tissues, and (3) possible roles of cytokines produced by human fetal membranes in the pathology of adverse pregnancy outcomes associated with influenza virus infection.

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CARDIOVASCULAR DISEASES ASSOCIATED WITH INFLUENZA INFECTION: SYSTEMATIC REVIEW AND META-ANALYSIS

10.1101/2021.08.11.21261941 ◽

2021 ◽

Author(s):

Maria del Carmen Caycho Torres ◽

Johnny Clavo Yamahuchi ◽

Cory Cornejo Ramos ◽

Katherine Ada Diaz Gomez ◽

Omar Zanoni Ramos ◽

...

Keyword(s):

Myocardial Infarction ◽

Systematic Review ◽

Acute Myocardial Infarction ◽

Influenza Virus ◽

Cardiovascular Diseases ◽

Influenza A ◽

Meta Analysis ◽

Influenza Virus Infection ◽

Cochrane Library ◽

Influenza B

Background: Cardiovascular diseases represent important diagnoses that can become fatal if an early and adequate management is not carried out. Since 1930, a possible relationship between these events and influenza virus infection has been proposed. Objectives: To determine the association between cardiovascular diseases and previous infection by influenza virus. Materials and methods: A systematic review was carried out according to PRISMA. The electronic search was carried out in the databases of EMBASE, PubMed, Global Index Medicus, Google Scholar and Cochrane Library. The included studies had laboratory-confirmed influenza in patients over 18 years of age; studies that considered pregnant patients or animals were excluded. The quality of the studies was verified using the standardized tool of the National Heart Lung and Blood Institute and the certainty of the results was assessed with GRADE. In addition, 2 meta-analysis of the association measures were performed using the Cochrane Software Review Manager 5.4.1. Results: 31 records were identified, of which 4 were included (n = 1101). These studies were conducted in Finland, China, and Australia. The estimated combined OR for the positive association between influenza A and acute myocardial infarction obtained was 2.52 (95% CI 1.59 - 4); and in the association with influenza B, an OR of 4.78 ( 95% CI 1.57-14.61). The OR obtained for the association with myocarditis was 5.23 (95% CI 1.00 - 27.32). Conclusions: Evidence of almost 5 times the risk of suffering acute myocardial infarction was found in those who had a previous episode of influenza B, and almost 3 with influenza A. Better quality longitudinal studies are required to confirm this finding.

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