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Table 1 Characteristics of the included studies

From: Effect of antiviral therapy on the outcomes of mechanically ventilated patients with herpes simplex virus detected in the respiratory tract: a systematic review and meta-analysis

Study

Design

Country

Patients (n)

Study period

Specimen and detection method

Clinical inclusion criteria

Immunosuppression

Primary endpoint

Secondary endpoints

Antiviral drug used (dosing), % of patients with therapy

Aisenberg et al. [26]

Single-centre, retrospective cohort study

USA

45

April 2000 to April 2004

BAL, viral culture alone or culture and cytology; HSV type not specified

Pneumonia

All patients with solid organ tumour

Hospital mortality

Median time on MV; median duration of ICU stay

Acyclovir (10 mg/kg tid), 68%; valacyclovir (1 g tid), 28%; famciclovir (500 mg tid), 4%

Camps et al. [17]

Single-centre, retrospective cohort study

Belgium

64

January 1992 to December 1997

BAL/TA, viral culture; HSV type not specified

Pneumonia

20%

Mortality

None

Acyclovir (5 mg tid 5 days),100%

Heimes et al. [27]

Single-centre, retrospective cohort study

Germany

306

January 2011 to December 2017

BAL/TA, PCR; HSV-1

Respiratory tract infection

34%

30-day mortality; survival

Hospital mortality; ICU mortality; length of hospital stay; length of ICU stay; duration of MV

Acyclovir (10 mg/kg tid 7 days), 91%; ganciclovir (no dose reported), 6%; both, 3%

Luyt et al. [7]

Single-centre, prospective cohort study

France

42

October 2004 to January 2006

BAL/TA, viral culture; HSV type not specified

Bronchopneumonitis in patients with prolonged MV (> 5 days)

Not specified

Hospital mortality

Length of ICU stay; duration MV; bacterial VAP

Acyclovir (10 mg/kg tid 5–14 days), 100%

Luyt et al. [28]

Double-blind, multicentre, placebo-controlled randomized clinical trial

France

238

February 2014 to February 2018

Oropharyngeal swab, PCR; HSV type not specified

MV for 96 h, predicted MV duration of ≥ 48 h and an HSV-positive oropharyngeal swab

Exclusion criteria

Ventilator-free days

60-day mortality; MV duration; occurrence of HSV bronchopneumonitis or active CMV infection; secondary bacterial pneumonia, bacteremia or fungemia; acute respiratory distress syndrome; septic shock post-randomization; acute renal failure

Acyclovir (5 mg/kg tid 14 days), 100%

Scheithauer et al. [5]

Single-centre, retrospective cohort study

Germany

51

January 2007 to April 2009

BAL/TA, PCR; HSV-1

Respiratory tract infection

Not specified

Hospital mortality

None

Acyclovir (no dose reported), 100%

Schuierer et al. [29, 30]

Single-centre, retrospective cohort study

Germany

89

January 2013 to April 2018

BAL/TA, PCR, HSV-1 and 2

Ventilator-associated pneumonia

Exclusion criteria: neutronpenic patients

Steroids at baseline: 17–20%

 

Hospital mortality; ICU mortality; length of hospital stay; length of ICU stay; duration of MV

Acyclovir (9 mg/kg tid) [median, IQR 7–11]. Total acyclovir treatment duration of surviving patients was 10 days [median, IQR 6.5–14], 97%; ganciclovir (no dose reported), 3%

Traen et al. [31]

Single-centre, retrospective cohort study

Belgium

212

January 2004 to March 2012

BAL/TA, viral culture, HSV-1

Respiratory tract infection

9%

Hospital mortality; ICU mortality; length of ICU stay; total MV duration; need for vasopressors; need for inotropics; SOFA score

None

Acyclovir (10 mg/kg tid over the course of 5–14 days), 100%

van den Brink et al. [11]

Single-centre, retrospective cohort study

Netherlands

22

February 1996 to November 2001

BAL, viral culture, HSV-1

Pneumonia

Not specified

Not defined

None

Acyclovir (10 mg/kg tid), 95%; ganciclovir (5 mg/kg bd), 0%; both, 5%

  1. BAL bronchoalveolar lavage, CMV Cytomegalovirus, HSV herpes simplex virus, HSV-1 HSV type 1, HSV-2 HSV type 2, ICU intensive care unit, MV mechanical ventilation, PCR polymerase chain reaction, SOFA sequential organ failure assessment, TA tracheal aspirate, VAP ventilator-associated pneumonia