Search

IntroductionDespite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in the quality and design of published studies.MethodsWe screened ongoing studies in our sequential, prospective meta-analysis. We pooled individual participant data to estimate the absolute and relative risk (RR) of adverse outcomes among pregnant women with SARS-CoV-2 infection, compared with confirmed negative pregnancies. We evaluated the risk of bias using a modified Newcastle-Ottawa Scale.ResultsWe screened 137 studies and included 12 studies in 12 countries involving 13 136 pregnant women.Pregnant women with SARS-CoV-2 infection-as compared with uninfected pregnant women-were at significantly increased risk of maternal mortality (10 studies; n=1490; RR 7.68, 95% CI 1.70 to 34.61); admission to intensive care unit (8 studies; n=6660; RR 3.81, 95% CI 2.03 to 7.17); receiving mechanical ventilation (7 studies; n=4887; RR 15.23, 95% CI 4.32 to 53.71); receiving any critical care (7 studies; n=4735; RR 5.48, 95% CI 2.57 to 11.72); and being diagnosed with pneumonia (6 studies; n=4573; RR 23.46, 95% CI 3.03 to 181.39) and thromboembolic disease (8 studies; n=5146; RR 5.50, 95% CI 1.12 to 27.12).Neonates born to women with SARS-CoV-2 infection were more likely to be admitted to a neonatal care unit after birth (7 studies; n=7637; RR 1.86, 95% CI 1.12 to 3.08); be born preterm (7 studies; n=6233; RR 1.71, 95% CI 1.28 to 2.29) or moderately preterm (7 studies; n=6071; RR 2.92, 95% CI 1.88 to 4.54); and to be born low birth weight (12 studies; n=11 930; RR 1.19, 95% CI 1.02 to 1.40). Infection was not linked to stillbirth. Studies were generally at low or moderate risk of bias.ConclusionsThis analysis indicates that SARS-CoV-2 infection at any time during pregnancy increases the risk of maternal death, severe maternal morbidities and neonatal morbidity, but not stillbirth or intrauterine growth restriction. As more data become available, we will update these findings per the published protocol.

Introduction Herpes simplex virus (HSV) infections are widespread among humans globally. (1,2) The infection is lifelong and characterized by periodic reactivations at the infection site. HSV type 1 is primarily [...], Objective To generate global and regional estimates for the prevalence and incidence of herpes simplex virus (HSV) type 1 and type 2 infection for 2016. Methods To obtain data, we undertook a systematic review to identify studies up to August 2018. Adjustments were made to account for HSV test sensitivity and specificity. For each World Health Organization (WHO) region, we applied a constant incidence model to pooled prevalence by age and sex to estimate the prevalence and incidence of HSV types 1 and 2 infections. For HSV type 1, we apportioned infection by anatomical site using pooled estimates of the proportions that were oral and genital. Findings In 2016, an estimated 491.5 million people (95% uncertainty interval, UI: 430.4 million-610.6 million) were living with HSV type 2 infection, equivalent to 13.2% of the world's population aged 15-49 years. An estimated 3752.0 million people (95% UI: 3555.5 million-3854.6 million) had HSV type 1 infection at any site, equivalent to a global prevalence of 66.6% in 0-49-year-olds. Differing patterns were observed by age, sex and geographical region, with HSV type 2 prevalence being highest among women and in the WHO African Region. Conclusion An estimated half a billion people had genital infection with HSV type 2 or type 1, and several billion had oral HSV type 1 infection. Millions of people may also be at higher risk of acquiring human immunodeficiency virus (HIV), particularly women in the WHO African Region who have the highest HSV type 2 prevalence and exposure to HIV. [phrase omitted] [phrase omitted] Objectif Estimer la prevalence et l'incidence, au niveau regional et mondial, des infections au virus Herpes simplex (HSV) de type 1 et de type 2 en 2016. Methodes Pour nous procurer les donnees necessaires, nous avons entrepris une revue systematique afin d'identifier des etudes publiees en aout 2018 au plus tard. Des ajustements ont ete effectues pour tenir compte de la sensibilite et de la specificite du depistage HSV. Pour chaque region definie par l'Organisation mondiale de la Sante (OMS), nous avons applique un modele d'incidence constante par groupe de prevalence en fonction de l'age et du sexe. Notre but etait d'estimer la prevalence et l'incidence des infections a HSV de type 1 et 2. Pour le HSV de type 1, nous avons reparti les infections selon le site anatomique, en utilisant des estimations groupees de la proportion d'atteintes orales et genitales. Resultats En 2016, environ 491,5 millions de personnes (intervalle d'incertitude de 95%: 430,4 millions--610,6 millions) vivaient avec une infection a HSV de type 2, l'equivalent de 13,2 % de la population mondiale entre 15 et 49 ans. Nous estimons que 3752,0 millions de personnes (intervalle d'incertitude de 95%: 3555,5 millions-3854,6 millions) souffraient d'une infection a HSV de type 1 a un site quelconque, ce qui represente une prevalence globale de 66,6% chez les 0-49 ans. Differentes tendances ont ete constatees en fonction de l'age, du sexe et de la zone geographique, le plus fort taux de prevalence de HSV de type 2 etant observe chez les femmes de la region Afrique de l'OMS. Conclusion Pres d'un demi-milliard de personnes presentaient une infection genitale a HSV de type 2 ou type 1, et plusieurs milliards avaient une infection orale a HSV de type 1. Des millions de personnes pourraient egalement etre plus susceptibles de contracter le virus de l'immunodeficience humaine (VIH), en particulier les femmes de la region Afrique de l'OMS qui possedent la plus grande prevalence de HSV de type 2 et sont davantage exposees au VIH. [phrase omitted] Objetivo Calcular las estimaciones mundiales y regionales de la prevalencia y la incidencia de la infeccion por el virus del herpes simple (VHS) tipo 1 y tipo 2 para 2016. Metodos Se realizo una revision sistematica para identificar los estudios hasta agosto de 2018 con el fin de obtener datos. Se hicieron ajustes para tener en cuenta la sensibilidad y la especificidad de la prueba de VHS. Se aplico un modelo de incidencia constante para cada region de la Organizacion Mundial de la Salud (OMS) con el fin de agrupar la prevalencia por edad y sexo para estimar la prevalencia y la incidencia de las infecciones por VHS de los tipos 1 y 2. Para el VHS tipo 1, se repartio la infeccion por sitio anatomico utilizando estimaciones agrupadas de los porcentajes que eran orales y genitales. Resultados En 2016, se estima que 491,5 millones de personas (95 % de intervalo de incertidumbre, UI: 430,4 millones a 610,6 millones) vivian con la infeccion por el VHS tipo 2, equivalente al 13,2 % de la poblacion mundial de 15 a 49 anos. Se estima que 3752,0 millones de personas (95 % UI: 3555,5 millones a 3854,6 millones) tenian la infeccion por VHS tipo 1 sin importar el lugar, lo que equivale a una prevalencia mundial del 66,6 % en las personas de 0 a 49 anos. Se observaron patrones diferentes segun la edad, el sexo y la region geografica, siendo la mayor prevalencia del VHS tipo 2 entre las mujeres y en la region de Africa de la OMS. Conclusion Se estima que 500 millones de personas tienen una infeccion genital con VHS tipo 2 o tipo 1, y varios miles de millones tienen una infeccion oral de VHS tipo 1. Millones de personas tambien pueden correr un mayor riesgo de contraer el virus de la inmunodeficiencia humana (VIH), en particular las mujeres de la Region de Africa de la OMS que tienen la mayor prevalencia del VHS tipo 2 y la mayor exposicion al VIH.