Prevalence of viral infection detected by PCR and RT‐PCR in patients with acute exacerbation of COPD: A systematic review
Identifieur interne : 000149 ( Istex/Corpus ); précédent : 000148; suivant : 000150Prevalence of viral infection detected by PCR and RT‐PCR in patients with acute exacerbation of COPD: A systematic review
Auteurs : Anant Mohan ; Subhash Chandra ; Dipti Agarwal ; Randeep Guleria ; Shobha Broor ; Bharti Gaur ; Ravindra Mohan PandeySource :
- Respirology [ 1323-7799 ] ; 2010-04.
Abstract
Background and objective: Viruses are important aetiological agents of acute exacerbation of COPD (AECOPD). Their reported prevalence varies from region to region. This systematic review calculated the prevalence of respiratory viral infections in AECOPD. Methods: A systematic search was performed using Medline, and references of relevant articles and conference proceedings were hand searched. Articles for review were selected based on the following criteria: (i) prospective or cross‐sectional study, (ii) original research, (iii) viral detection used the highly sensitive techniques of PCR and/or Reverse Transcriptase PCR (RT‐PCR), (iv) viral prevalence in AECOPD defined, and (v) full paper available in English. We assessed the study quality and extracted data independently and in duplicate using a pre‐defined data extraction form. Weighted mean prevalence (WMP) was calculated and a forest plot was constructed to show the dispersion. Results: Eight studies met the inclusion criteria. The WMP of respiratory viral infection in AECOPD was 34.1% (95% CI: 23.9–44.4). picornavirus was the most commonly detected virus with WMP 17.3% (95% CI: 7.2–27.3), followed by influenza; 7.4% (95% CI: 2.9–12.0), respiratory syncytial virus; 5.3% (95% CI: 1.6–9.0), corona viruses; 3.1% (95% CI: 0.4–5.8), parainfluenza; 2.6% (95% CI: 0.4–4.8), adenovirus; 1.1% (95% CI: −1.1 to 3.3), and human metapneumovirus; 0.7% (95% CI: −0.3 to 1.8). Maximum WMP was observed in studies from Europe followed by the USA, Australia and Asia. Picorna was the most common virus detected in Western countries whereas influenza was most common in Asia. Conclusions: This systematic review demonstrated that viruses are strongly associated with AECOPD, with the highest detection rates of viruses being in Europe. The geographical epidemiology of viruses may have important therapeutic implications for management of AECOPD.
Viruses are an important cause of acute exacerbation of COPD (AECOPD). This systematic review calculated the weighted mean prevalence (WMP) of respiratory viruses detected in patients with AECOPD. The overall WMP was 34.1% (95% CI: 23.9‐44.4), and picornavirus was the most commonly detected virus with WMP 17.3% (95% CI: 7.2‐27.3).
Url:
DOI: 10.1111/j.1440-1843.2010.01722.x
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Agarwal</name><affiliation><mods:affiliation>Department of Medicine, Mayo Clinic, RoChester, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Guleria, Randeep" sort="Guleria, Randeep" uniqKey="Guleria R" first="Randeep" last="Guleria">Randeep Guleria</name><affiliation><mods:affiliation>All India Institute of Medical Sciences, New Delhi, India, and</mods:affiliation></affiliation></author><author><name sortKey="Broor, Shobha" sort="Broor, Shobha" uniqKey="Broor S" first="Shobha" last="Broor">Shobha Broor</name><affiliation><mods:affiliation>All India Institute of Medical Sciences, New Delhi, India, and</mods:affiliation></affiliation></author><author><name sortKey="Gaur, Bharti" sort="Gaur, Bharti" uniqKey="Gaur B" first="Bharti" last="Gaur">Bharti Gaur</name><affiliation><mods:affiliation>All India Institute of Medical Sciences, New Delhi, India, and</mods:affiliation></affiliation></author><author><name sortKey="Pandey, Ravindra Mohan" sort="Pandey, 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first="Anant" last="Mohan">Anant Mohan</name><affiliation><mods:affiliation>All India Institute of Medical Sciences, New Delhi, India, and</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: anantmohan@yahoo.com</mods:affiliation></affiliation></author><author><name sortKey="Chandra, Subhash" sort="Chandra, Subhash" uniqKey="Chandra S" first="Subhash" last="Chandra">Subhash Chandra</name><affiliation><mods:affiliation>Department of Medicine, Mayo Clinic, RoChester, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Agarwal, Dipti" sort="Agarwal, Dipti" uniqKey="Agarwal D" first="Dipti" last="Agarwal">Dipti Agarwal</name><affiliation><mods:affiliation>Department of Medicine, Mayo Clinic, RoChester, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Guleria, Randeep" sort="Guleria, Randeep" uniqKey="Guleria R" first="Randeep" last="Guleria">Randeep Guleria</name><affiliation><mods:affiliation>All India Institute of Medical Sciences, New Delhi, India, and</mods:affiliation></affiliation></author><author><name sortKey="Broor, Shobha" sort="Broor, Shobha" uniqKey="Broor S" first="Shobha" last="Broor">Shobha Broor</name><affiliation><mods:affiliation>All India Institute of Medical Sciences, New Delhi, India, and</mods:affiliation></affiliation></author><author><name sortKey="Gaur, Bharti" sort="Gaur, Bharti" uniqKey="Gaur B" first="Bharti" last="Gaur">Bharti Gaur</name><affiliation><mods:affiliation>All India Institute of Medical Sciences, New Delhi, India, and</mods:affiliation></affiliation></author><author><name sortKey="Pandey, Ravindra Mohan" sort="Pandey, Ravindra Mohan" uniqKey="Pandey R" first="Ravindra Mohan" last="Pandey">Ravindra Mohan Pandey</name><affiliation><mods:affiliation>All India Institute of Medical Sciences, New Delhi, India, and</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Respirology</title><title level="j" type="alt">RESPIROLOGY</title><idno type="ISSN">1323-7799</idno><idno type="eISSN">1440-1843</idno><imprint><biblScope unit="vol">15</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="536">536</biblScope><biblScope unit="page" to="542">542</biblScope><biblScope unit="page-count">7</biblScope><publisher>Blackwell Publishing Asia</publisher><pubPlace>Melbourne, Australia</pubPlace><date type="published" when="2010-04">2010-04</date></imprint><idno type="ISSN">1323-7799</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1323-7799</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background and objective: Viruses are important aetiological agents of acute exacerbation of COPD (AECOPD). Their reported prevalence varies from region to region. This systematic review calculated the prevalence of respiratory viral infections in AECOPD. Methods: A systematic search was performed using Medline, and references of relevant articles and conference proceedings were hand searched. Articles for review were selected based on the following criteria: (i) prospective or cross‐sectional study, (ii) original research, (iii) viral detection used the highly sensitive techniques of PCR and/or Reverse Transcriptase PCR (RT‐PCR), (iv) viral prevalence in AECOPD defined, and (v) full paper available in English. We assessed the study quality and extracted data independently and in duplicate using a pre‐defined data extraction form. Weighted mean prevalence (WMP) was calculated and a forest plot was constructed to show the dispersion. Results: Eight studies met the inclusion criteria. The WMP of respiratory viral infection in AECOPD was 34.1% (95% CI: 23.9–44.4). picornavirus was the most commonly detected virus with WMP 17.3% (95% CI: 7.2–27.3), followed by influenza; 7.4% (95% CI: 2.9–12.0), respiratory syncytial virus; 5.3% (95% CI: 1.6–9.0), corona viruses; 3.1% (95% CI: 0.4–5.8), parainfluenza; 2.6% (95% CI: 0.4–4.8), adenovirus; 1.1% (95% CI: −1.1 to 3.3), and human metapneumovirus; 0.7% (95% CI: −0.3 to 1.8). Maximum WMP was observed in studies from Europe followed by the USA, Australia and Asia. Picorna was the most common virus detected in Western countries whereas influenza was most common in Asia. Conclusions: This systematic review demonstrated that viruses are strongly associated with AECOPD, with the highest detection rates of viruses being in Europe. The geographical epidemiology of viruses may have important therapeutic implications for management of AECOPD.</div><div type="abstract">Viruses are an important cause of acute exacerbation of COPD (AECOPD). This systematic review calculated the weighted mean prevalence (WMP) of respiratory viruses detected in patients with AECOPD. 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virus</value></json:item></subject><articleId><json:string>RESP1722</json:string></articleId><arkIstex>ark:/67375/WNG-GJLZ3SS9-K</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Background and objective: Viruses are important aetiological agents of acute exacerbation of COPD (AECOPD). Their reported prevalence varies from region to region. This systematic review calculated the prevalence of respiratory viral infections in AECOPD. Methods: A systematic search was performed using Medline, and references of relevant articles and conference proceedings were hand searched. Articles for review were selected based on the following criteria: (i) prospective or cross‐sectional study, (ii) original research, (iii) viral detection used the highly sensitive techniques of PCR and/or Reverse Transcriptase PCR (RT‐PCR), (iv) viral prevalence in AECOPD defined, and (v) full paper available in English. We assessed the study quality and extracted data independently and in duplicate using a pre‐defined data extraction form. Weighted mean prevalence (WMP) was calculated and a forest plot was constructed to show the dispersion. Results: Eight studies met the inclusion criteria. The WMP of respiratory viral infection in AECOPD was 34.1% (95% CI: 23.9–44.4). picornavirus was the most commonly detected virus with WMP 17.3% (95% CI: 7.2–27.3), followed by influenza; 7.4% (95% CI: 2.9–12.0), respiratory syncytial virus; 5.3% (95% CI: 1.6–9.0), corona viruses; 3.1% (95% CI: 0.4–5.8), parainfluenza; 2.6% (95% CI: 0.4–4.8), adenovirus; 1.1% (95% CI: −1.1 to 3.3), and human metapneumovirus; 0.7% (95% CI: −0.3 to 1.8). Maximum WMP was observed in studies from Europe followed by the USA, Australia and Asia. Picorna was the most common virus detected in Western countries whereas influenza was most common in Asia. Conclusions: This systematic review demonstrated that viruses are strongly associated with AECOPD, with the highest detection rates of viruses being in Europe. The geographical epidemiology of viruses may have important therapeutic implications for management of AECOPD.</abstract><qualityIndicators><score>8.571</score><pdfWordCount>3571</pdfWordCount><pdfCharCount>24236</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>7</pdfPageCount><pdfPageSize>595.276 x 779.528 pts</pdfPageSize><pdfWordsPerPage>510</pdfWordsPerPage><pdfText>true</pdfText><refBibsNative>true</refBibsNative><abstractWordCount>275</abstractWordCount><abstractCharCount>1908</abstractCharCount><keywordCount>3</keywordCount></qualityIndicators><title>Prevalence of viral infection detected by PCR and RT‐PCR in patients with acute exacerbation of COPD: A systematic review</title><pmid><json:string>20415983</json:string></pmid><genre><json:string>article</json:string></genre><host><title>Respirology</title><language><json:string>unknown</json:string></language><doi><json:string>10.1111/(ISSN)1440-1843</json:string></doi><issn><json:string>1323-7799</json:string></issn><eissn><json:string>1440-1843</json:string></eissn><publisherId><json:string>RESP</json:string></publisherId><volume>15</volume><issue>3</issue><pages><first>536</first><last>542</last><total>7</total></pages><genre><json:string>journal</json:string></genre></host><namedEntities><unitex><date><json:string>2001</json:string><json:string>1134</json:string><json:string>2010</json:string></date><geogName></geogName><orgName><json:string>SPSS Inc., Chicago</json:string><json:string>Department of Medicine</json:string><json:string>American Thoracic Society</json:string><json:string>All India Institute of Medical Sciences, New Delhi</json:string><json:string>Department of Medicine, Mayo Clinic</json:string><json:string>Ireland, UK</json:string><json:string>World Health Organization</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Hong Kong</json:string><json:string>Grant Waterer</json:string><json:string>Seemungal</json:string><json:string>Poole</json:string><json:string>Rohde</json:string></persName><placeName><json:string>Australia</json:string><json:string>India</json:string><json:string>Europe</json:string><json:string>York</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>January 2009</json:string><json:string>Rohde et al.</json:string><json:string>McManus et al.</json:string><json:string>Seemungal et al.</json:string><json:string>Anthonisen et al.</json:string><json:string>Mohan et al.</json:string><json:string>Germany (2003)</json:string><json:string>Nichol et al.</json:string><json:string>Hutchinson et al.</json:string><json:string>Hong Kong (2007)</json:string><json:string>Ko et al.</json:string><json:string>Beckham et al.</json:string><json:string>Camargo et al.</json:string><json:string>Australia (2007)</json:string><json:string>Papi et al.</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/WNG-GJLZ3SS9-K</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - respiratory system</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - clinical medicine</json:string><json:string>3 - respiratory system</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Pulmonary and Respiratory Medicine</json:string></scopus><inist><json:string>1 - sciences appliquees, technologies et medecines</json:string><json:string>2 - sciences biologiques et medicales</json:string><json:string>3 - sciences medicales</json:string></inist></categories><publicationDate>2010</publicationDate><copyrightDate>2010</copyrightDate><doi><json:string>10.1111/j.1440-1843.2010.01722.x</json:string></doi><id>B226495B7E963E4FE5AC5D5ECFBDD02352CE15A2</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-GJLZ3SS9-K/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-GJLZ3SS9-K/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/WNG-GJLZ3SS9-K/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">Prevalence of viral infection detected by PCR and RT‐PCR in patients with acute exacerbation of COPD: A systematic review</title><title level="a" type="short">Viral infections in COPD</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Blackwell Publishing Asia</publisher><pubPlace>Melbourne, Australia</pubPlace><availability><licence>© 2010 The Authors; Journal compilation © 2010 Asian Pacific Society of Respirology</licence></availability><date type="published" when="2010-04"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">Prevalence of viral infection detected by PCR and RT‐PCR in patients with acute exacerbation of COPD: A systematic review</title><title level="a" type="short">Viral infections in COPD</title><author xml:id="author-0000" role="corresp"><persName><forename type="first">Anant</forename><surname>MOHAN</surname></persName><affiliation><orgName type="institution">All India Institute of Medical Sciences</orgName><address><addrLine>New Delhi</addrLine><addrLine>India, and</addrLine><country key="IN" xml:lang="en">INDIA</country></address></affiliation></author><author xml:id="author-0001"><persName><forename type="first">Subhash</forename><surname>CHANDRA</surname></persName><affiliation><orgName type="division">Department of Medicine</orgName><address><addrLine>Mayo Clinic</addrLine><addrLine>RoChester, New York, USA</addrLine><country key="US" xml:lang="en">UNITED STATES</country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">Dipti</forename><surname>AGARWAL</surname></persName><affiliation><orgName type="division">Department of Medicine</orgName><address><addrLine>Mayo Clinic</addrLine><addrLine>RoChester, New York, USA</addrLine><country key="US" xml:lang="en">UNITED STATES</country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Randeep</forename><surname>GULERIA</surname></persName><affiliation><orgName type="institution">All India Institute of Medical Sciences</orgName><address><addrLine>New Delhi</addrLine><addrLine>India, and</addrLine><country key="IN" xml:lang="en">INDIA</country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Shobha</forename><surname>BROOR</surname></persName><affiliation><orgName type="institution">All India Institute of Medical Sciences</orgName><address><addrLine>New Delhi</addrLine><addrLine>India, and</addrLine><country key="IN" xml:lang="en">INDIA</country></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">Bharti</forename><surname>GAUR</surname></persName><affiliation><orgName type="institution">All India Institute of Medical Sciences</orgName><address><addrLine>New Delhi</addrLine><addrLine>India, and</addrLine><country key="IN" xml:lang="en">INDIA</country></address></affiliation></author><author xml:id="author-0006"><persName><forename type="first">Ravindra Mohan</forename><surname>PANDEY</surname></persName><affiliation><orgName type="institution">All India Institute of Medical Sciences</orgName><address><addrLine>New Delhi</addrLine><addrLine>India, and</addrLine><country key="IN" xml:lang="en">INDIA</country></address></affiliation></author><idno type="istex">B226495B7E963E4FE5AC5D5ECFBDD02352CE15A2</idno><idno type="ark">ark:/67375/WNG-GJLZ3SS9-K</idno><idno type="DOI">10.1111/j.1440-1843.2010.01722.x</idno><idno type="unit">RESP1722</idno><idno type="toTypesetVersion">file:RESP.RESP1722.pdf</idno></analytic><monogr><title level="j" type="main">Respirology</title><title level="j" type="alt">RESPIROLOGY</title><idno type="pISSN">1323-7799</idno><idno type="eISSN">1440-1843</idno><idno type="book-DOI">10.1111/(ISSN)1440-1843</idno><idno type="book-part-DOI">10.1111/res.2010.15.issue-3</idno><idno type="product">RESP</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">15</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="536">536</biblScope><biblScope unit="page" to="542">542</biblScope><biblScope unit="page-count">7</biblScope><publisher>Blackwell Publishing Asia</publisher><pubPlace>Melbourne, Australia</pubPlace><date type="published" when="2010-04"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><encodingDesc><schemaRef type="ODD" url="https://xml-schema.delivery.istex.fr/tei-istex.odd"></schemaRef><appInfo><application ident="pub2tei" version="1.0.10" when="2019-12-20"><label>pub2TEI-ISTEX</label><desc>A set of style sheets for converting XML documents encoded in various scientific publisher formats into a common TEI format.
<ref target="http://www.tei-c.org/">We use TEI</ref></desc></application></appInfo></encodingDesc><profileDesc><abstract xml:lang="en" style="main"><head>ABSTRACT</head><p><hi rend="bold">Background and objective: </hi> Viruses are important aetiological agents of acute exacerbation of COPD (AECOPD). Their reported prevalence varies from region to region. This systematic review calculated the prevalence of respiratory viral infections in AECOPD.</p><p><hi rend="bold">Methods: </hi> A systematic search was performed using Medline, and references of relevant articles and conference proceedings were hand searched. Articles for review were selected based on the following criteria: (i) prospective or cross‐sectional study, (ii) original research, (iii) viral detection used the highly sensitive techniques of PCR and/or Reverse Transcriptase PCR (RT‐PCR), (iv) viral prevalence in AECOPD defined, and (v) full paper available in English. We assessed the study quality and extracted data independently and in duplicate using a pre‐defined data extraction form. Weighted mean prevalence (WMP) was calculated and a forest plot was constructed to show the dispersion.</p><p><hi rend="bold">Results: </hi> Eight studies met the inclusion criteria. The WMP of respiratory viral infection in AECOPD was 34.1% (95% CI: 23.9–44.4). picornavirus was the most commonly detected virus with WMP 17.3% (95% CI: 7.2–27.3), followed by influenza; 7.4% (95% CI: 2.9–12.0), respiratory syncytial virus; 5.3% (95% CI: 1.6–9.0), corona viruses; 3.1% (95% CI: 0.4–5.8), parainfluenza; 2.6% (95% CI: 0.4–4.8), adenovirus; 1.1% (95% CI: −1.1 to 3.3), and human metapneumovirus; 0.7% (95% CI: −0.3 to 1.8). Maximum WMP was observed in studies from Europe followed by the USA, Australia and Asia. Picorna was the most common virus detected in Western countries whereas influenza was most common in Asia.</p><p><hi rend="bold">Conclusions: </hi> This systematic review demonstrated that viruses are strongly associated with AECOPD, with the highest detection rates of viruses being in Europe. The geographical epidemiology of viruses may have important therapeutic implications for management of AECOPD.</p></abstract><abstract style="short"><p>Viruses are an important cause of acute exacerbation of COPD (AECOPD). This systematic review calculated the weighted mean prevalence (WMP) of respiratory viruses detected in patients with AECOPD. The overall WMP was 34.1% (95% CI: 23.9‐44.4), and picornavirus was the most commonly detected virus with WMP 17.3% (95% CI: 7.2‐27.3).</p></abstract><textClass><keywords xml:lang="en"><term xml:id="k1">chronic obstructive pulmonary disease</term><term xml:id="k2">polymerase chain reaction</term><term xml:id="k3">respiratory virus</term></keywords><keywords rend="tocHeading1"><term>ORIGINAL ARTICLES</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc><revisionDesc><change when="2019-12-20" who="#istex" xml:id="pub2tei">formatting</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/WNG-GJLZ3SS9-K/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Asia</publisherName><publisherLoc>Melbourne, Australia</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1440-1843</doi><issn type="print">1323-7799</issn><issn type="electronic">1440-1843</issn><idGroup><id type="product" value="RESP"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="RESPIROLOGY">Respirology</title></titleGroup></publicationMeta><publicationMeta level="part" position="04003"><doi origin="wiley">10.1111/res.2010.15.issue-3</doi><numberingGroup><numbering type="journalVolume" number="15">15</numbering><numbering type="journalIssue" number="3">3</numbering></numberingGroup><coverDate startDate="2010-04">April 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="20" status="forIssue"><doi origin="wiley">10.1111/j.1440-1843.2010.01722.x</doi><idGroup><id type="unit" value="RESP1722"></id></idGroup><countGroup><count type="pageTotal" number="7"></count></countGroup><titleGroup><title type="tocHeading1">ORIGINAL ARTICLES</title></titleGroup><copyright>© 2010 The Authors; Journal compilation © 2010 Asian Pacific Society of Respirology</copyright><eventGroup><event type="firstOnline" date="2010-03-29"></event><event type="publishedOnlineFinalForm" date="2010-03-29"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.6 mode:FullText source:FullText result:FullText" date="2010-05-18"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-08"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-03"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="536">536</numbering><numbering type="pageLast" number="542">542</numbering></numberingGroup><correspondenceTo>Anant Mohan, Department of Medicine, All India Institute of Medical Sciences, New Delhi 110029, India. Email: <email>anantmohan@yahoo.com</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:RESP.RESP1722.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Received 22 October 2009; invited to revise 4 November 2009; revised 19 November 2009; accepted 3 December 2009 (Associate Editor: Grant Waterer).</unparsedEditorialHistory><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="4"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="27"></count><count type="wordTotal" number="4231"></count><count type="linksPubMed" number="0"></count><count type="linksCrossRef" number="0"></count></countGroup><titleGroup><title type="main">Prevalence of viral infection detected by PCR and RT‐PCR in patients with acute exacerbation of COPD: A systematic review</title><title type="shortAuthors">A Mohan <i>et al.</i></title><title type="short">Viral infections in COPD</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1" corresponding="yes"><personName><givenNames>Anant</givenNames><familyName>MOHAN</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2"><personName><givenNames>Subhash</givenNames><familyName>CHANDRA</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a2"><personName><givenNames>Dipti</givenNames><familyName>AGARWAL</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a1"><personName><givenNames>Randeep</givenNames><familyName>GULERIA</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a1"><personName><givenNames>Shobha</givenNames><familyName>BROOR</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a1"><personName><givenNames>Bharti</givenNames><familyName>GAUR</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a1"><personName><givenNames>Ravindra Mohan</givenNames><familyName>PANDEY</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="IN"><unparsedAffiliation>All India Institute of Medical Sciences, New Delhi, India, and</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="US"><unparsedAffiliation>Department of Medicine, Mayo Clinic, RoChester, New York, USA</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">chronic obstructive pulmonary disease</keyword><keyword xml:id="k2">polymerase chain reaction</keyword><keyword xml:id="k3">respiratory virus</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">ABSTRACT</title><p><b>Background and objective: </b> Viruses are important aetiological agents of acute exacerbation of COPD (AECOPD). Their reported prevalence varies from region to region. This systematic review calculated the prevalence of respiratory viral infections in AECOPD.</p><p><b>Methods: </b> A systematic search was performed using Medline, and references of relevant articles and conference proceedings were hand searched. Articles for review were selected based on the following criteria: (i) prospective or cross‐sectional study, (ii) original research, (iii) viral detection used the highly sensitive techniques of PCR and/or Reverse Transcriptase PCR (RT‐PCR), (iv) viral prevalence in AECOPD defined, and (v) full paper available in English. We assessed the study quality and extracted data independently and in duplicate using a pre‐defined data extraction form. Weighted mean prevalence (WMP) was calculated and a forest plot was constructed to show the dispersion.</p><p><b>Results: </b> Eight studies met the inclusion criteria. The WMP of respiratory viral infection in AECOPD was 34.1% (95% CI: 23.9–44.4). picornavirus was the most commonly detected virus with WMP 17.3% (95% CI: 7.2–27.3), followed by influenza; 7.4% (95% CI: 2.9–12.0), respiratory syncytial virus; 5.3% (95% CI: 1.6–9.0), corona viruses; 3.1% (95% CI: 0.4–5.8), parainfluenza; 2.6% (95% CI: 0.4–4.8), adenovirus; 1.1% (95% CI: −1.1 to 3.3), and human metapneumovirus; 0.7% (95% CI: −0.3 to 1.8). Maximum WMP was observed in studies from Europe followed by the USA, Australia and Asia. Picorna was the most common virus detected in Western countries whereas influenza was most common in Asia.</p><p><b>Conclusions: </b> This systematic review demonstrated that viruses are strongly associated with AECOPD, with the highest detection rates of viruses being in Europe. The geographical epidemiology of viruses may have important therapeutic implications for management of AECOPD.</p></abstract><abstract type="short"><p>Viruses are an important cause of acute exacerbation of COPD (AECOPD). This systematic review calculated the weighted mean prevalence (WMP) of respiratory viruses detected in patients with AECOPD. The overall WMP was 34.1% (95% CI: 23.9‐44.4), and picornavirus was the most commonly detected virus with WMP 17.3% (95% CI: 7.2‐27.3).</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Prevalence of viral infection detected by PCR and RT‐PCR in patients with acute exacerbation of COPD: A systematic review</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Viral infections in COPD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Prevalence of viral infection detected by PCR and RT‐PCR in patients with acute exacerbation of COPD: A systematic review</title></titleInfo><name type="personal"><namePart type="given">Anant</namePart><namePart type="family">MOHAN</namePart><affiliation>All India Institute of Medical Sciences, New Delhi, India, and</affiliation><affiliation>E-mail: anantmohan@yahoo.com</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Subhash</namePart><namePart type="family">CHANDRA</namePart><affiliation>Department of Medicine, Mayo Clinic, RoChester, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Dipti</namePart><namePart type="family">AGARWAL</namePart><affiliation>Department of Medicine, Mayo Clinic, RoChester, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Randeep</namePart><namePart type="family">GULERIA</namePart><affiliation>All India Institute of Medical Sciences, New Delhi, India, and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Shobha</namePart><namePart type="family">BROOR</namePart><affiliation>All India Institute of Medical Sciences, New Delhi, India, and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bharti</namePart><namePart type="family">GAUR</namePart><affiliation>All India Institute of Medical Sciences, New Delhi, India, and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ravindra Mohan</namePart><namePart type="family">PANDEY</namePart><affiliation>All India Institute of Medical Sciences, New Delhi, India, and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Blackwell Publishing Asia</publisher><place><placeTerm type="text">Melbourne, Australia</placeTerm></place><dateIssued encoding="w3cdtf">2010-04</dateIssued><edition>Received 22 October 2009; invited to revise 4 November 2009; revised 19 November 2009; accepted 3 December 2009 (Associate Editor: Grant Waterer).</edition><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">2</extent><extent unit="tables">4</extent><extent unit="formulas">0</extent><extent unit="references">27</extent><extent unit="linksCrossRef">0</extent><extent unit="words">4231</extent></physicalDescription><abstract lang="en">Background and objective: Viruses are important aetiological agents of acute exacerbation of COPD (AECOPD). Their reported prevalence varies from region to region. This systematic review calculated the prevalence of respiratory viral infections in AECOPD. Methods: A systematic search was performed using Medline, and references of relevant articles and conference proceedings were hand searched. Articles for review were selected based on the following criteria: (i) prospective or cross‐sectional study, (ii) original research, (iii) viral detection used the highly sensitive techniques of PCR and/or Reverse Transcriptase PCR (RT‐PCR), (iv) viral prevalence in AECOPD defined, and (v) full paper available in English. We assessed the study quality and extracted data independently and in duplicate using a pre‐defined data extraction form. Weighted mean prevalence (WMP) was calculated and a forest plot was constructed to show the dispersion. Results: Eight studies met the inclusion criteria. The WMP of respiratory viral infection in AECOPD was 34.1% (95% CI: 23.9–44.4). picornavirus was the most commonly detected virus with WMP 17.3% (95% CI: 7.2–27.3), followed by influenza; 7.4% (95% CI: 2.9–12.0), respiratory syncytial virus; 5.3% (95% CI: 1.6–9.0), corona viruses; 3.1% (95% CI: 0.4–5.8), parainfluenza; 2.6% (95% CI: 0.4–4.8), adenovirus; 1.1% (95% CI: −1.1 to 3.3), and human metapneumovirus; 0.7% (95% CI: −0.3 to 1.8). Maximum WMP was observed in studies from Europe followed by the USA, Australia and Asia. Picorna was the most common virus detected in Western countries whereas influenza was most common in Asia. Conclusions: This systematic review demonstrated that viruses are strongly associated with AECOPD, with the highest detection rates of viruses being in Europe. The geographical epidemiology of viruses may have important therapeutic implications for management of AECOPD.</abstract><abstract type="short">Viruses are an important cause of acute exacerbation of COPD (AECOPD). This systematic review calculated the weighted mean prevalence (WMP) of respiratory viruses detected in patients with AECOPD. 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