?:abstract
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Acute respiratory tract infections (ARI) constitute a substantial disease burden in adults and elderly individuals We aimed to identify all case-control studies investigating the potential role of respiratory viruses in the etiology of ARI in older adults aged ≥65 years We conducted a systematic literature review (across 7 databases) of case-control studies published from 1996 to 2017 that investigated the viral profile of older adults with and those without ARI We then computed a pooled odds ratio (OR) with a 95% confidence interval and virus-specific attributable fraction among the exposed (AFE) for 8 common viruses: respiratory syncytial virus (RSV), influenza virus (Flu), parainfluenza virus (PIV), human metapneumovirus (HMPV), adenovirus (AdV), rhinovirus (RV), bocavirus (BoV), and coronavirus (CoV) From the 16 studies included, there was strong evidence of possible causal attribution for RSV (OR, 8 5 [95% CI, 3 9–18 5];AFE, 88%), Flu (OR, 8 3 [95% CI, 4 4–15 9];AFE, 88%), PIV (OR, not available;AFE, approximately 100%), HMPV (OR, 9 8 [95% CI, 2 3–41 0];AFE, 90%), AdV (OR, not available;AFE, approximately 100%), RV (OR, 7 1 [95% CI, 3 7–13 6];AFE, 86%) and CoV (OR, 2 8 [95% CI, 2 0–4 1];AFE, 65%) in older adults presenting with ARI, compared with those without respiratory symptoms (ie, asymptomatic individuals) or healthy older adults However, there was no significant difference in the detection of BoV in cases and controls This review supports RSV, Flu, PIV, HMPV, AdV, RV, and CoV as important causes of ARI in older adults and provides quantitative estimates of the absolute proportion of virus-associated ARI cases to which a viral cause can be attributed Disease burden estimates should take into account the appropriate AFE estimates (for older adults) that we report [ABSTRACT FROM AUTHOR] Copyright of Journal of Infectious Diseases is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder\'s express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )
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