Crimean‐Congo hemorrhagic fever‐induced liver injury: a systematic review and meta‐analysis

Background: Crimean-Congo hemorrhagic fever (CCHF) is a fatal acute tick-borne viral infection and a substantial emerging global public health threat. This illness has a high case fatality rate of up to 40%. The liver is one of the important target organs of the CCHF virus. Objective: The aim of this meta-analysis to evaluate the correlation between CCHF and liver injury and draw more generalized inferences about the abnormal serum markers of liver injury such as alanine aminotransferase (ALT), aspartate aminotransferase (AST) in CCHF patients. Methods: A literature search was accomplished for published eligible articles with MEDLINE/PubMed and Embase databases. All eligible observational studies and case series were included from around the world. The inclusion criteria were articles describing liver injury biomarkers AST and ALT amongst patients diagnosed with CCHF. Results: Data from 18 studies, consisting of 1238 patients with CCHF were included in this meta-analysis. The overall pooled prevalence of at least one raised liver injury biomarker was 77.95% (95% CI, I2 = 88.50%, p < 0.0001). Similarly, pooled prevalence of elevated AST and ALT was 85.92% (95% CI, I2 = 85.27%, p < 0.0001) and 64.30% (95% CI, I2 = 88.32%, p < 0.0001) respectively. Both Egger and Begg-Mazumdar’s tests detected no apparent publication bias in all three meta-analyses(p > 0.05). Conclusion: These elevated liver injury biomarkers have been identified as significant prognostic factors. Hence, Physicians must recognize and continuously monitor these biomarkers, since these aid early stratification of prognosis and the prevention of severe outcomes in infection with such a high case fatality rate.

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New aspects about Crimean-Congo hemorrhagic fever (CCHF) cases and associated fatality trends: A global systematic review and meta-analysis

Comparative Immunology Microbiology and Infectious Diseases ◽

10.1016/j.cimid.2020.101429 ◽

2020 ◽

Vol 69 ◽

pp. 101429 ◽

Cited By ~ 5

Author(s):

Hassan Nasirian

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Hemorrhagic Fever ◽

Crimean Congo Hemorrhagic Fever

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Worldwide epidemiology of Crimean-Congo Hemorrhagic Fever Virus in humans, ticks and other animal species, a systematic review and meta-analysis

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009299 ◽

2021 ◽

Vol 15 (4) ◽

pp. e0009299

Author(s):

Jean Thierry Ebogo Belobo ◽

Sebastien Kenmoe ◽

Cyprien Kengne-Nde ◽

Cynthia Paola Demeni Emoh ◽

Arnol Bowo-Ngandji ◽

...

Keyword(s):

Systematic Review ◽

Low Income ◽

Animal Species ◽

Meta Analysis ◽

Random Effect ◽

Case Fatality ◽

Hemorrhagic Fever ◽

Fever Virus ◽

Crimean Congo Hemorrhagic Fever ◽

Hemorrhagic Fever Virus

There are uncertainties about the global epidemiological data of infections due to Crimean-Congo hemorrhagic fever virus (CCHFV). We estimated the global case fatality rate (CFR) of CCHFV infections and the prevalence of CCHFV in humans, ticks and other animal species. We also explored the socio-demographic and clinical factors that influence these parameters. In this systematic review with meta–analyses we searched publications from database inception to 03rd February 2020 in Pubmed, Scopus, and Global Index Medicus. Studies included in this review provided cross-sectional data on the CFR and/or prevalence of one or more targets used for the detection of CCHFV. Two independent investigators selected studies to be included. Data extraction and risk of bias assessment were conducted independently by all authors. Data collected were analysed using a random effect meta-analysis. In all, 2345 records were found and a total of 312 articles (802 prevalence and/or CFR data) that met the inclusion criteria were retained. The overall CFR was 11.7% (95% CI = 9.1–14.5), 8.0% (95% CI = 1.0–18.9), and 4.7% (95% CI = 0.0–37.6) in humans with acute, recent, and past CCHFV infections respectively. The overall CCHFV acute infections prevalence was 22.5% (95% CI = 15.7–30.1) in humans, 2.1% (95% CI = 1.3–2.9) in ticks, and 4.5% (95% CI = 1.9–7.9) in other animal species. The overall CCHFV recent infections seroprevalence was 11.6% (95% CI = 7.9–16.4) in humans and 0.4% (95% CI = 0.0–2.9) in other animal species. The overall CCHFV past infections seroprevalence was 4.3% (95% CI = 3.3–5.4) in humans and 12.0% (95% CI = 9.9–14.3) in other animal species. CFR was higher in low-income countries, countries in the WHO African, South-East Asia and Eastern Mediterranean regions, in adult and ambulatory patients. CCHFV detection rate in humans were higher in CCHFV suspected cases, healthcare workers, adult and hospitalized patients, ticks of the genus Ornithodoros and Amblyomma and in animals of the orders Perissodactyla and Bucerotiformes. This review highlights a significant disease burden due to CCHFV with a strong disparity according to country income levels, geographic regions, various human categories and tick and other animal species. Preventive measures in the light of these findings are expected.

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Faculty Opinions recommendation of Systematic Review and Meta-analysis of Postexposure Prophylaxis for Crimean-Congo Hemorrhagic Fever Virus among Healthcare Workers.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.733867512.793551591 ◽

2018 ◽

Author(s):

Heinz Feldmann

Keyword(s):

Systematic Review ◽

Healthcare Workers ◽

Meta Analysis ◽

Hemorrhagic Fever ◽

Fever Virus ◽

Postexposure Prophylaxis ◽

Crimean Congo Hemorrhagic Fever ◽

Hemorrhagic Fever Virus

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Ribavirin for Crimean-Congo hemorrhagic fever: systematic review and meta-analysis

BMC Infectious Diseases ◽

10.1186/1471-2334-10-207 ◽

2010 ◽

Vol 10 (1) ◽

Cited By ~ 65

Author(s):

Karla Soares-Weiser ◽

Sherine Thomas ◽

Gail Thomson G ◽

Paul Garner

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Hemorrhagic Fever ◽

Crimean Congo Hemorrhagic Fever

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Crimean-Congo hemorrhagic fever (CCHF) seroprevalence: A systematic review and meta-analysis

Acta Tropica ◽

10.1016/j.actatropica.2019.05.019 ◽

2019 ◽

Vol 196 ◽

pp. 102-120 ◽

Cited By ~ 7

Author(s):

Hassan Nasirian

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Hemorrhagic Fever ◽

Crimean Congo Hemorrhagic Fever

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Systematic Review and Meta-analysis of Postexposure Prophylaxis for Crimean-Congo Hemorrhagic Fever Virus among Healthcare Workers

Emerging Infectious Diseases ◽

10.3201/eid2409.171709 ◽

2018 ◽

Vol 24 (9) ◽

pp. 1642-1648 ◽

Cited By ~ 11

Author(s):

Önder Ergönül ◽

Şiran Keske ◽

Melis Gökçe Çeldir ◽

İlayda Arjen Kara ◽

Natalia Pshenichnaya ◽

...

Keyword(s):

Systematic Review ◽

Healthcare Workers ◽

Meta Analysis ◽

Hemorrhagic Fever ◽

Fever Virus ◽

Postexposure Prophylaxis ◽

Crimean Congo Hemorrhagic Fever ◽

Hemorrhagic Fever Virus

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Prevention and management of idiosyncratic drug-induced liver injury: Systematic review and meta-analysis of randomised clinical trials

Pharmacological Research ◽

10.1016/j.phrs.2020.105404 ◽

2021 ◽

Vol 164 ◽

pp. 105404

Author(s):

Hao Niu ◽

Judith Sanabria-Cabrera ◽

Ismael Alvarez-Alvarez ◽

Mercedes Robles-Diaz ◽

Simona Stankevičiūtė ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Liver Injury ◽

Meta Analysis ◽

Randomised Clinical Trials ◽

Drug Induced ◽

Drug Induced Liver Injury

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Mesenchymal Stem Cell Therapy for Acetaminophen-Related Liver Injury: A Systematic Review and Meta-Analysis of Experimental Studies in Vivo

Current Stem Cell Research & Therapy ◽

10.2174/1574888x16666211007092055 ◽

2021 ◽

Vol 16 ◽

Author(s):

Li Wang ◽

Yiwen Zhang ◽

Jiajun Zhong ◽

Yuan Zhang ◽

Shuisheng Zhou ◽

...

Keyword(s):

Systematic Review ◽

Stem Cell ◽

Liver Injury ◽

Mesenchymal Stem Cell ◽

Small Sample Size ◽

Meta Analysis ◽

Experimental Studies ◽

Small Sample ◽

Control Group

Objective: The efficacy of mesenchymal stem cell (MSC) therapy in acetaminophen-induced liver injury has been investigated in animal experiments, but individual studies with a small sample size cannot be used to draw a clear conclusion. Therefore, we conducted a systematic review and meta-analysis of preclinical studies to explore the potential of using MSCs in acetaminophen-induced liver injury. Methods: Eight databases were searched for studies reporting the effects of MSCs on acetaminophen hepatoxicity. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were used. SYRCLE’s risk of bias tool for animal studies was applied to assess the methodological quality. A meta-analysis was performed by using RevMan 5.4 and STATA/SE 16.0 software. Results: Eleven studies involving 159 animals were included according to PRISMA statement guidelines. Significant associations were found for MSCs with the levels of alanine transaminase (ALT) (standardized mean difference (SMD) − 2.58, p < 0.0001), aspartate aminotransferase (AST) (SMD − 1.75, p = 0.001), glutathione (GSH) (SMD 3.7, p < 0.0001), superoxide dismutase (SOD) (SMD 1.86, p = 0.022), interleukin 10 (IL-10) (SMD 5.14, p = 0.0002) and tumor necrosis factor-α (TNF-α) (SMD − 4.48, p = 0.011) compared with those in the control group. The subgroup analysis showed that the tissue source of MSCs significantly affected the therapeutic efficacy (p < 0.05). Conclusion: Our meta-analysis results demonstrate that MSCs could be a potential treatment for acetaminophen-related liver injury.

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