Powassan Virus Infections: A Systematic Review of Published Cases.

Autor:	Kakoullis L; Department of Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA.; Harvard Medical School, Boston, MA 02115, USA., Vaz VR; Department of Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA.; Harvard Medical School, Boston, MA 02115, USA., Kaur D; Department of Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA.; Harvard Medical School, Boston, MA 02115, USA., Kakoulli S; Medical School, University of Groningen, 9712 Groningen, The Netherlands., Panos G; Division of Infectious Diseases, Department of Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece., Chen LH; Harvard Medical School, Boston, MA 02115, USA.; Division of Infectious Diseases and Travel Medicine, Department of Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA., Behlau I; Harvard Medical School, Boston, MA 02115, USA.; Division of Infectious Diseases and Travel Medicine, Department of Medicine, Mount Auburn Hospital, Cambridge, MA 02138, USA.; Molecular Biology and Microbiology and Ophthalmology, Tufts Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA 02111, USA.
Jazyk:	angličtina
Zdroj:	Tropical medicine and infectious disease [Trop Med Infect Dis] 2023 Nov 26; Vol. 8 (12). Date of Electronic Publication: 2023 Nov 26.
DOI:	10.3390/tropicalmed8120508
Abstrakt:	Background: Powassan virus is an emerging neurotropic arbovirus transmitted by the tick Ixodes scapularis. This systematic review was conducted to aggregate data on its clinical manifestations, diagnostic findings, and complications. Methods: PubMed was searched until August 2023 using the term "Powassan", to identify all published cases of Powassan virus infections, as per PRISMA guidelines. Results: Among the 380 abstracts identified, 45 studies describing 84 cases (70 adult, 14 pediatric) were included. Cases were reported from the USA and Canada. Complications included paralysis in 44.1% of adult and 42.6% of pediatric cases, cognitive deficits in 33.3% of adult and 25% of pediatric cases, while the mortality rate was 19.1% and 7.1% in the adult and pediatric populations, respectively. Correlation analysis revealed an association between mortality and age (r = 0.264, p = 0.029), development of paralysis (r = 0.252, p = 0.041), or respiratory distress or failure (r = 0.328, p = 0.006). Factors associated with persistent neurological deficits were development of ataxia (r = 0.383, p = 0.006), paralysis (r = 0.278, p = 0.048), speech disorder (r = 0.319, p = 0.022), and cranial nerve involvement (r = 0.322, p = 0.017). Other significant correlations included those between speech disorders and ataxia (r = 0.526, p < 0.001), and between paralysis and respiratory distress or failure (r = 0.349, p = 0.003). Conclusion: Powassan virus infections have significant morbidity and mortality and should be suspected in cases of encephalitis and possible tick exposure. PROSPERO registration number: CRD42023395991.
Databáze:	MEDLINE
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