scholarly journals Risk Factors for Herpes Zoster Infection: A Meta-Analysis

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Fawziah Marra ◽  
Kamalpreet Parhar ◽  
Bill Huang ◽  
Nirma Vadlamudi
Keyword(s):  
Risk Factors ◽  
Herpes Zoster ◽  
Lupus Erythematosus ◽  
Meta Analysis ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Physical Trauma

Abstract Background The burden of herpes zoster (HZ) is significant worldwide, with millions affected and the incidence rising. Current literature has identified some risk factors for this disease; however, there is yet to be a comprehensive study that pools all evidence to provide estimates of risk. Therefore, the purpose of this study is to identify various risk factors, excluding immunosuppressive medication, that may predispose an individual to developing HZ. Methods The literature search was conducted in MEDLINE, EMBASE, and Cochrane Central, yielding case control, cohort, and cross-sectional studies that were pooled from January 1966 to September 2017. Search terms included the following: zoster OR herpe* OR postherpe* OR shingle* AND risk OR immunosupp* OR stress OR trauma OR gender OR ethnicity OR race OR age OR diabetes OR asthma OR chronic obstructive pulmonary disease OR diabetes. Risk ratios (RRs) for key risk factors were calculated via natural logarithms and pooled using random-effects modeling. Results From a total of 4417 identified studies, 88 were included in analysis (N = 3, 768 691 HZ cases). Immunosuppression through human immunodeficiency virus/acquired immune deficiency syndrome (RR = 3.22; 95% confidence interval [CI], 2.40–4.33) or malignancy (RR = 2.17; 95% CI, 1.86–2.53) significantly increased the risk of HZ compared with controls. Family history was also associated with a greater risk (RR = 2.48; 95% CI, 1.70–3.60), followed by physical trauma (RR = 2.01; 95% CI, 1.39–2.91) and older age (RR = 1.65; 95% CI, 1.37–1.97). A slightly smaller risk was seen those with psychological stress, females, and comorbidities such as diabetes, rheumatoid arthritis, cardiovascular diseases, renal disease, systemic lupus erythematosus, and inflammatory bowel disease compared with controls (RR range, 2.08–1.23). We found that black race had lower rates of HZ development (RR = 0.69; 95% CI, 0.56–0.85). Conclusions This study demonstrated a number of risk factors for development of HZ infection. However, many of these characteristics are known well in advance by the patient and clinician and may be used to guide discussions with patients for prevention by vaccination.

scholarly journals 2302. A Meta-Analysis of Risk Factors for Herpes Zoster Infection

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S788-S789
Author(s):  
Kamalpreet K Parhar ◽  
Bill Huang ◽  
Nirma K Vadlamudi ◽  
Fawziah Marra
Keyword(s):  
Risk Factors ◽  
Herpes Zoster ◽  
Family History ◽  
Meta Analysis ◽  
Older Age ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Physical Trauma ◽  
Random Effects Modeling

Abstract Background The burden of herpes zoster (HZ) is significant worldwide, with millions affected and the incidence rising. Current literature has identified some risk factors for this disease; however, there is yet to be a comprehensive study that pools all evidence to provide estimates of risk. Therefore, The purpose of this study was to identify various risk factors, excluding immunosuppressive medication, that may predispose an individual to developing herpes zoster. Methods The literature search was conducted in MEDLINE, EMBASE, Cochrane Central, Cochrane Systematic Reviews, Web of Science, CAB Direct, yielding case–control, cohort and cross-sectional studies that were pooled from January 1966 to September 2018. Search terms included: zoster OR herpe*OR postherpe*OR shingle*AND riskOR immunosupp*OR stress OR trauma OR gender OR ethnicity OR race OR age OR diabetes OR asthma OR chronic obstructive pulmonary disease OR diabetes. Risk ratios for key risk factors were calculated via natural logarithms and pooled using random effects modeling. Results From a total of 4417 identified studies, 93 were included in analysis (n = 3826134 HZ cases). Immunosuppression through HIV/AIDS (RR 3.25; 95% CI 2.47–4.27) or malignancy (RR 2.17; 95% CI 1.86–2.53) significantly increased the risk of HZ compared with controls. Family history was also associated with a greater risk (RR 2.48; 95% CI 1.70–3.60), followed by physical trauma (RR 2.01; 95% CI 1.39–2.91) and older age (RR 1.68; 95% CI 1.41–2.01). A slightly smaller risk was seen those with psychological stress, females, and comorbidities such as diabetes, rheumatoid arthritis, cardiovascular diseases, renal disease, SLE, and IBD compared with controls (RR range: 2.08 to 1.25). We found that black race had lower rates of HZ development RR 0.69 (95% CI 0.56–0.85). Conclusion This study demonstrated patients with family history of HZ, older age, female sex, have particular comorbidities or are immunosuppressed have an elevated risk of herpes zoster. Patients with these characteristics are prime candidates for vaccination. Disclosures All authors: No reported disclosures.

scholarly journals Risk Factors for Herpes Zoster: a Systematic Review and Meta-Analysis

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S313-S314
Author(s):  
Kosuke Kawai ◽  
Barbara P Yawn
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Herpes Zoster ◽  
Family History ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Physical Trauma ◽  
Increased Risk ◽  
Race Ethnicity

Abstract Background Well-recognized risk factors for herpes zoster (HZ), commonly known as shingles, are age and immunosuppression. Numerous studies have investigated other various risk factors for HZ in recent years. The objective of our study is to systematically review studies examining risk factors for HZ and discuss implications based on the updated evidence. Methods We performed a literature search using PubMed, Embase, and Web of Science and included studies that examined risk factors for HZ. Random effects model was used to summarize the risk ratio (RR) or odds ratio (OR) and 95% confidence interval (CI). Results Of the 3450 studies screened, we included 84 studies in the systematic review and conducted meta-analysis in 62 studies. Women are at increased risk of HZ compared with men (pooled adjusted RR = 1.31; 95% CI: 1.27, 1.34). Black individuals have almost half the risk of HZ than White individuals (pooled RR = 0.54; 95% CI: 0.47, 0.63). Family history was found to be a risk factor for HZ (pooled OR = 3.59; 95% CI: 2.39, 5.40). Autoimmune diseases, including rheumatoid arthritis (pooled RR = 1.67; 95% CI: 1.41, 1.98) and systemic lupus erythematous (RR = 2.10; 95% CI: 1.40, 3.15), were associated with an elevated risk of HZ. Other comorbidities were associated with an increased risk of HZ, with the pooled RRs ranging from 1.25 (95% CI: 1.13, 1.39) for asthma to 1.30 (1.17, 1.45) for diabetes mellitus, and 1.31 (95% CI: 1.22, 1.41) for chronic obstructive pulmonary disease. Statin use was also associated with a modest increased risk of HZ (pooled RR = 1.14; 95% CI: 1.11, 1.17). Recent physical trauma increased risk of HZ by almost two-fold (pooled RR = 2.56; 95% CI: 1.97, 3.33). Conclusion In addition to age and immunocompromised conditions, our review shows that female sex, race/ethnicity, family history, and comorbidities are risk factors for HZ. Efforts are needed to better understand risk factors and to increase the uptake of zoster vaccination. Disclosures B. P. Yawn, GSK: Consultant and Scientific Advisor, Consulting fee

scholarly journals Clinical Characteristics and Risk Factors for Myocardial Injury and Arrhythmia in COVID-19 patients

2020 ◽  
Author(s):  
Hong Gang Ren ◽  
Xingyi Guo ◽  
Lei Tu ◽  
Qinyong Hu ◽  
Kevin Blighe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Myocardial Injury ◽  
Heart Diseases ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
History Of ◽  
Cross Sectional Design

ABSTRACTBackgroundPatients with COVID-19 can develop myocardial injury and arrhythmia during the course of their illness. However, the underlying risk factors for the development of cardiovascular related manifestations are unclear.MethodsUsing a register-based multi-center cross-sectional design, we analyzed 80 patients with myocardial injury and 401 controls, as well as 71 patients with arrhythmia and 409 controls, all admitted with COVID-19. Putative risk factors for myocardial injury and arrhythmia were evaluated with logistic regression with adjustment for potential confounders.ResultsCOVID-19 patients with myocardial injury had fatigue (66.2%) and dyspnea (63.7%), while those with arrhythmia had dyspnea (71.8%). Patients with myocardial injury and arrhythmia had a significant mortality of 92.5% and 94.4%, respectively. A history of chronic obstructive pulmonary disease (COPD) or heart diseases was associated with an increased risk of myocardial injury (odds ratio [OR] = 1.94, 95% confidence interval [CI]: 1.01-3.71; OR = 7.43, 95% CI: 3.99-13.83) and arrhythmia (OR = 1.94, 95% CI: 1.00-3.75; OR = 13.16, 95% CI: 6.75-25.68). In addition, we found that gamma glutamyltranspeptidase (GGT) >50U/L (OR = 2.14, 95% CI: 1.37-3.32; OR = 1.85, 95% CI: 1.19-2.85), serum creatinine >111μmol/L (OR = 8.96, 95% CI: 4.4-18.23; OR = 3.71, 95% CI: 2.01-6.85), serum sodium <136 mmol/L (OR = 4.68, 95% CI: 2.46-8.91; OR = 2.06; 95% CI: 1.06-4.00) were all associated with increased risk of myocardial injury and arrhythmia, respectively.ConclusionOur reported clinical characteristics and identified risk factors are important for clinical study of COVID-19 patients developing myocardial injury and arrhythmia.

scholarly journals Association of occupational dust exposure with combined chronic obstructive pulmonary disease and pneumoconiosis: a cross-sectional study in China

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038874
Author(s):  
Yali Fan ◽  
Wenjing Xu ◽  
Yuanying Wang ◽  
Yiran Wang ◽  
Shiwen Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cross Sectional Study ◽  
Dust Exposure ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Heavy Smoking ◽  
Occupational Dust Exposure ◽  
Coal Workers Pneumoconiosis ◽  
Coal Workers

ObjectivesOccupational dust exposure may induce various lung diseases, including pneumoconiosis and chronic obstructive pulmonary disease (COPD). The features of combined COPD and pneumoconiosis have not been well described, and this may hamper the management. This study aimed to describe the prevalence and characteristics as well as the risk factors of the combined diseases.DesignA cross-sectional study.Setting and participants758 patients with pneumoconiosis were recruited at a single-medical centre. Of these, 675 patients with pneumoconiosis, including asbestosis, silicosis, coal workers’ pneumoconiosis and other pneumoconiosis, was eligible for analysis.Primary outcome measuresCOPD was diagnosed based on clinical features and/or history of exposure to risk factors and post bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7. Clinical data were collected from predesigned medical reports. The patients underwent both chest radiograph and high-resolution CT scans. Risk factors for combined COPD and pneumoconiosis were analysed using regression analysis.ResultsCOPD prevalence overall was 32.7% (221/675) and was the highest in silicosis (84/221) and coal workers’ pneumoconiosis (100/221). COPD prevalence increased with smoking pack-years, dust exposure duration and pneumoconiosis stage. Patients with combined diseases had lower body mass index, higher smoking index and worse pulmonary function. Risk factors for combined diseases included heavy smoking, silica or coal exposure and advanced pneumoconiosis. The interaction between dust exposure and smoking in COPD was also identified. The risk of combined COPD significantly increased with heavy smoking and silica or coal exposure (OR 5.49, 95% CI 3.04 to 9.93, p<0.001).ConclusionsCOPD is highly prevalent in patients with pneumoconiosis, especially patients with silicosis and coal workers’ pneumoconiosis. Occupational dust exposure as well as heavy smoking is associated with an increased risk of combined COPD and pneumoconiosis, which demands an effective preventive intervention.

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