Regional, age and respiratory-secretion-specific prevalence of respiratory viruses associated with asthma exacerbation: a literature review
Despite increased understanding of how viral infection is involved in asthma exacerbations, it is less clear which viruses are involved and to what extent they contribute to asthma exacerbations. Here, we sought to determine the prevalence of different respiratory viruses during asthma exacerbations. Systematic computerized searches of the literature up to June 2017 without language limitation were performed. The primary focus was on the prevalence of respiratory viruses, including AdV (adenovirus), BoV (bocavirus), CoV (coronavirus), CMV (cytomegalovirus), EnV (enterovirus), HSV (herpes simplex virus), IfV (influenza virus), MpV (metapneumovirus), PiV (parainfluenzavirus), RV (rhinovirus) and RSV (respiratory syncytial virus) during asthma exacerbations. We also examined the prevalence of viral infection stratified by age, geographic region, type of respiratory secretion, and detection method. Sixty articles were included in the final analysis. During asthma exacerbations, the mean prevalence of AdV, BoV, CoV, CMV, EnV, HSV, IfV, MpV, PiV, RV and RSV was 3.8%, 6.9%, 8.4%, 7.2%, 10.1%, 12.3%, 10.0%, 5.3%, 5.6%, 42.1% and 13.6%, respectively. EnV, MPV, RV and RSV were more prevalent in children, whereas AdV, BoV, CoV, IfV and PiV were more frequently present in adults. RV was the major virus detected globally, except in Africa. RV could be detected in both the upper and lower airway. Polymerase chain reaction was the most sensitive method for detecting viral infection. Our findings indicate the need to develop prophylactic polyvalent or polyvirus (including RV, EnV, IfV and RSV) vaccines that produce herd immunity and reduce the healthcare burden associated with virus-induced asthma exacerbations.
X. Y. Z. and W. J. G. drafted the manuscript, X. Y. Z., Y. J. X. and W. J. G. collected data, X. Y. Z. performed statistical analysis, X. Y. Z., W. J. G. and L. F. L. contributed to study conception, W. J. G. and L. F. L. provided critical review of the manuscript and approved the final submission. W. J. G. is the guarantor of the study.
Compliance with ethical standards
Guangdong Province Universities and Colleges Pearl River Scholar Funded Scheme 2017 (to Dr. Guan).
Conflict of interest
Xue-yan Zheng declares that she had no conflict of interest. Yan-jun Xu declares that she had no conflict of interest. Li-feng Lin declares that he had no conflict of interest. Wei-jie Guan declares that he had no conflict of interest.
This article does not contain any studies with human participants performed by any of the authors.
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