SynthesisCritical care (London, England)2020
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.
Synthesis in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 37 citations in OpenAlex.
- Viral Reactivation in Immunocompetent Critically Ill Patients.Microorganisms · 2026Review
- Current practices in the diagnosis and management of HSV and CMV reactivation in German ICUs: an exploratory web-based survey.Frontiers in medicine · 2026Article
- Observational
- Respiratory Microbiome in Elderly Patients on Prolonged Mechanical Ventilation: A Prospective Multi-Center Observational Study.Clinical interventions in aging · 2025Observational
- Viral reactivations and fungal infections in nonresolving acute respiratory distress syndrome.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Herpes simplex virus and cytomegalovirus lung reactivations in severe COVID-19 patients: to treat or not to treat? That is (still) the question.Intensive care medicine · 2024Article
- Pulmonary herpes simplex virus and cytomegalovirus in patients with acute respiratory distress syndrome related to COVID-19.Intensive care medicine · 2024Observational
- Article
- Diagnostic Dilemma of Herpes Simplex Virus Type 1 Pneumonia or Colonization: A Case Report.Infection and drug resistance · 2024Article
- Review
- Viral infections in critical care: a narrative review.Anaesthesia · 2023Review
- Multiple Organ Dysfunction Secondary to Herpes Simplex Virus -1 Reactivation After Treatment With Dexamethasone and Sarilumab for Covid-19 Disease.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2023Article
- Next-Generation Sequencing in Critically Ill COVID-19 Patients with Suspected Bloodstream Infections: A Retrospective Cohort Study.Journal of clinical medicine · 2023Article
- Viral reactivation in the lungs of patients with severe pneumonia is associated with increased mortality, a multicenter, retrospective study.Journal of medical virology · 2023Article
- Herpesvirus reactivation in respiratory tract is associated with increased mortality of severe pneumonia patients and their respiratory microbiome dysbiosis.Frontiers in cellular and infection microbiology · 2023Article
- Herpes Simplex Virus 1 (HSV-1) Reactivation in Critically Ill COVID-19 Patients: A Brief Narrative Review.Infectious diseases and therapy · 2022Review
- An Unusual Cause of Acute Isolated Hepatitis in a Cancer Patient Post-COVID Pneumonia: HSV-2.Infectious diseases & clinical microbiology · 2022Article
- Incidence and Outcome of Patients with Cardiogenic Shock and Detection of Herpes Simplex Virus in the Lower Respiratory Tract.Journal of clinical medicine · 2022Article
- HSV-1 reactivation is associated with an increased risk of mortality and pneumonia in critically ill COVID-19 patients.Critical care (London, England) · 2021Observational
- Management of infectious complications associated with coronavirus infection in severe patients admitted to ICU.Medicina intensiva · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHerpes simplex virus (HSV) is frequently detected in the respiratory tract of mechanically ventilated patients. The aim of this study was to assess current evidence to determine whether antiviral therapy is associated with better outcomes in these patients.
methodsMEDLINE, ISI Web of Science, Cochrane Database and ClinicalTrials.gov were searched from inception to 25 May 2020. All clinical studies investigating the effects of antiviral therapy on the outcome of mechanically ventilated ICU patients in whom HSV was detected in the respiratory tract were eligible for inclusion, regardless of study design, publication status or language. Titles and abstracts were reviewed independently by two authors. If the articles seemed eligible, full-text articles were reviewed and data extracted. We performed a random-effects meta-analysis to estimate relative risks (RRs) with corresponding 95% confidence intervals (CIs). The primary endpoint was hospital all-cause mortality.
resultsNine studies were included in the meta-analysis (one randomized controlled trial, eight cohort studies). Antiviral treatment was associated with lower hospital mortality (with antiviral treatment, 40.6% (189 out of 465 patients); without, 52.7% (193 out of 366 patients); RR 0.74 [0.64, 0.85]; eight studies, low quality of evidence). Furthermore, antiviral treatment was associated with lower 30-day mortality (RR 0.75 [0.59, 0.94]; three studies, very low quality of evidence). We did not observe evidence for differences in ICU mortality (RR 0.73 [0.51, 1.05]; three studies, very low quality of evidence).
conclusionsThis meta-analysis of the available data shows that antiviral therapy might result in lower hospital and 30-day all-cause mortality in mechanically ventilated ICU patients who are positive for HSV in the respiratory tract. However, this result must be interpreted with great caution due to the high risk of bias and limited number of patients. Large, well-designed randomized controlled clinical trials are urgently needed.
trial registrationThe study was registered in advance on International Prospective Register of Systematic Reviews (CRD42020180053) .
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.