Table 1 Characteristics of 32 included studies in this meta-analysis
| First author | Country | Year | Sex | Age | Total | Viral genotypes | N | Bacterial species | N | Diagnosis | Method | Sample type | Smoking | Drugs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
Ueda [39] | Japan | 1992 | 46 M/20 F | 61.5 | 66 | HCV | 19 | NA | NA | Clinical, radiologica, physiological, and histological grounds | ELISA, RIBA | Serum | NA | CS |
|
Meliconi [40] | Italy | 1996 | 43 M/18 F | 61 | 60 | HCV | 8 | NA | NA | Clinical, radiological, physiological, and histological grounds | RT-PCR, ELISA, RIBA | Serum | NA | Immunosuppressive treatment |
|
Kuwano [41] | Japan | 1997 | 8 M/11 F | 62 | 19 | Adenovirus | 3 | NA | NA | Clinical, radiological, physiological, and histological grounds | Nested PCR,ISH | Lung | Yes | CS |
|
Yonemaru [10] | Japan | 1997 | 30 M/13 F | 63 | 43 | CMV,Adenovirus, EBV, HSV, Parainfluenza | 42 CMV,Adeno, EBV, HSV /43Parainfluenza 3 | NA | NA | Clinical, radiological, physiological, and histological grounds | EIA,CF, HI | Serum | NA | NA |
|
Stewart [42] | United Kingdom | 1999 | 19 M/8 F | 57 | 27 | EBV | 13 | NA | NA |
UIP pattern at histopathologic examination and HRCT | PCR | Lung | Yes | CyA, Az, Pred, cyclophosphamide |
|
Tsukamoto [43] | Japan | 2000 | 22 M/7 F | 57.33 | 25 | EBV | 24 | NA | NA | UIP pattern at histopathologic examination | PCR | Lung | Yes | None |
|
Tang [44] | United States | 2001 | NA | NA | 23 | EBV,CMV, HHV, HSV/VZV/HHV | 7CMV,15EBV,19HHV | NA | NA | UIP pattern at histopathologic examination | PCR | Lung | NA | NA |
|
Lok [45] | United Kingdom | 2001 | 10 M/4 F | 59 | 14 | EBV | 8 | NA | NA |
UIP pattern at histopathologic examination and HRCT |
PCR, IHC | Lung | NA | NA |
|
Kelly [46] | United Kingdom | 2002 | 15 M/11 F | 52.2 | 27 | EBV | 23 | NA | NA |
UIP pattern at histopathologic examination and HRCT | PCR | Serum | NA | CsA/prednisolone/azathioprine |
|
Magro [47] | United States | 2003 | 11 M/8 F | 50.9 | 19 | CMV, Parvovirus B19 | 9 CMV, 9B19 | NA | NA | UIP pattern at histopathologic examination | IndirectImmunofluorescentRodent Lung Assay | Serum- lung biopsy | NA | NA |
|
Tang [48] | United States | 2003 | 23 M/10 F | 55.27 | 33 | CM, HHV, EBV | 21EBV, 7CMV, 29HHV | NA | NA | UIP pattern at histopathologic examination | PCR | Lung | NA | Prednisone,CytoxanImuran,CytoxaNeoralActimmune |
| Dworniczak[49] | Poland | 2004 | 9 M/7 F | 40.9 | 16 | CMV | 12 | NA | NA | ATS/ERS statement 2000 | Q-PCR | BALFBlood-Serum | Yes | Never treated |
|
Miyake [50] | Japan | 2005 | 94 M/10 F | NA | 104 | HCV | 7 | NA | NA | ATS/ERS statement 2002 | NA | Medicalhistory | Yes | NA |
|
Lawson [32] | United States | 2008 | NA | NA | 23 | EBV-KSHV- CMV | 8EBC, 8CMV, 2KSHV | NA | NA |
ATS/ERS statement2000, ATS/ERS statement 2002 | IHC | Lung | NA | NA |
|
Bando [51] | Japan | 2008 | 43 M/14 F | NA | 57 | TTV | 55 | NA | NA | ATS/ERS statement 2000 | PCR | Serum | yes | NA |
| Pozharskaya[52] | United States | 2009 | NA | NA | 13 | EBV | 9 | NA | NA | UIP pattern at histopathologic examination | PCR | Lung | NA | NA |
|
Song [21] | South Korea | 2011 | 358 M/103 F | 63.4 | 461 | CMV, Influenza, RSV | 7CMV, 1Influenza, 1RSV |
S. pneumoniae, MRSA, H. influenzae, Legionella, K pneumonia,M. tuberculosis | 2S.pneumoniae,1MRSA,4H.influenzae,1Legionella, 1 K.Pneumoniae, 1 M. tuberculosis | ATS/ERS statement 2001 | Retrospective review | BALF | Yes | Steroid with or without cytotoxic therapy |
|
Wootton [9] | Korea | 2011 | 68 M/15 F | 64.06 | 83 | TTV | 12 | NA | NA |
ATS/ERS statement 2000 Collard et al. 2007 | PCR | BALF | Yes | CS with or without immunomodulator therapy |
|
Lasithiotaki [53] | Greece | 2011 | NA | NA | 11 and 13 | HHV, HSV | 1HSV, 5HHV | NA | NA | ATS/ERS statement 2000 | PCR | Lung, BALF | Yes | NA |
|
Pulkkinen [54] | Finland | 2012 | 11 M/1 F | 57.3 | 12 | EBV, HHV,HSV,CMV | 11EBV,12HHV,2HSV,2CMV | NA | NA |
ATS/ERS statement 2000, ATS/ERS statement 2002 | PCR | Lung | Yes | Prednisolone; cyclosporin A |
|
Calabrese [55] | Canada | 2013 | 39 M/16 F | 55.2 | 55 | HHV-6, PV B19, CM, EBV | 7HHV, 4CMV, 13EBV | NA | NA | ATS/ERS statement 2002 | PCR, IHC | Lung tissues | Yes | NA |
|
dos Santos [56] | Brazil | 2013 | 7 M/6 F | 65 | 13 | MV, CMV | 2MV, 1CMV | NA | NA | ATS/ERS statement 2002 | IHC | Surgical lung biopsy | NA | NA |
|
Folcik [57] | USA | 2013 | 14 M/7 F | 60.6 | 21 | HVS | 21 | NA | NA |
ATS/ERS/JRS/ALAT statement, Raghu et al 2011 | ISH, IHC | Lung | NA | NA |
|
Bando [58] | Japan | 2014 | 5 M/4 F | 71.4 | 9 | TTV | 9 | Nontuberculus mycobacterium, Streptococcus pneumoniae, Haemophilus influenzae | 3 |
ATS/ERS/JRS/ALAT statement, Raghu et al. 2012 | Real-Time PCR, culture | Serum-sputum | Yes |
Steroids/immunosuppressants/ PFD |
|
Ushiki [59] | Japan | 2014 | 11 M/3 F | 69.5 | 14 | RSV,CMV | 1RSV, 0CMV | NA | NA | Collard et al. 2007 | PCR | BAL | NA | Not treated |
|
Rabea [60] | Egypt | 2015 | 13 M/17 F | 52.4 | 30 | HCV | 9 | NA | NA | ATS/ERS statement2002 | ELISA | Serum | Yes | NA |
|
Keyvani [24] | Iran | 2017 | 22 M/18 F | 66.62 | 40 |
RSV, Parainfluenza, Rhino, Corona, Influenza | 1RSV, 3 parainfluenza,4 rhino,1corona,0 influenza | NA | NA | CT scan | DNA array assay | Nasopharyngeal, BAL | NA | NA |
|
Saraya [61] | Japan | 2018 | 18 M/9 F | 74 | 27 | HHV,HPIV,CMV | 3 HHV, 2CMV, 1HPIV | NA | NA | Collard et al. 2007, Collard et al. 2016 | PCR | Nasal swab, sputu, BALF | Yes | Antifibroticagent/CS oral /CSpulseintravenous CY/oral + CsA/CY |
|
Weng [62] | China | 2019 | NA | NA | 149 | CMV, Adenovirus, Influenza B, RSV | 2CMV, Adenovirus, 4Influenza B, 6RSV | Mycoplasma, Legionella, Chlamydia | 11,Mycoplasma, 8Legionella, 1Chlamydia |
ATS/ERS/JRS/ALAT statement, Raghu et al. 2011 | IgM ELISA | Serum | Yes | Glucocorticoids, antibiotics, glutathione, immune support therapy |
|
Weng [62] | China | 2019 |
AEIPF48M/0 F StableIPF110M/12 F |
AE-IPF = 65 stable IPF = 64 | 170 | NA | NA |
Klebsiella pneumoniae, Acinetobacter baumannii, Mycobacterium tuberculosis, Pseudomonas aeruginosa, Serratia marcescense, Raoultella |
10 K. pneumoniae,4A.baumannii, 8 M tuberculosis,3P.aeruginosa, 1S.marcescen, 1Raoultella |
ATS/ERS/JRS/ALAT statement, Raghu et al. 2011 | Culture | Sputum | Yes | Glucocorticoids, antibiotics, glutathione, immune support therapy |
|
Le Hingrat [63] | France | 2020 | 17 M/2 F | 58 | 19 | HHV,CMV,EBV,TTV | 15HHV,2CMV,12EBV,12TTV | NA | NA |
ATS/ERS/JRS/ALAT statement, Raghu et al. 2011 | Real-Time PCR | Lung | Yes | PFD, nintedanib, prednisone |
|
Odashima [22] | Japan | 2020 | 497 M/162 F | 70.2 | 659 | NA | NA | NTM, M. tuberculosis | 35NTM, 23 M.tuberculosis |
ATS/ERS/JRS/ALATstatement, Raghu et al. 2011 | Retrospective cohort | Retrospective cohort | Yes | Steroid,Immunosuppressant |
|
Jafarian [64] | Iran | 2020 | 16 M/13 F | 58 | 29 | EBV, HHV | 6EBV,3HHV | NA | NA |
ATS/ERS/JRS/ALAT statement, Wells et al. 2013 | PCR | Lung | NA | NA |