Comparison of the clinical manifestations and chest CT findings of pulmonary cryptococcosis in immunocompetent and immunocompromised patients: a systematic review and meta-analysis

作者全名："Xiong, Chunlin; Lu, Jianguo; Chen, Ting; Xu, Rui"

作者地址："[Chen, Ting] Chongqing Med Univ, Affiliated Hosp 2, Dept Radiol, Chongqing 400010, Peoples R China; [Xiong, Chunlin] Peoples Hosp Fengjie, Dept Cardiol, Chongqing 404600, Peoples R China; [Lu, Jianguo] Peoples Hosp Fengjie, Dept Radiol, Chongqing 404600, Peoples R China; [Xu, Rui] Chongqing Med Univ, Affiliated Hosp 2, Dept Resp Med, Chongqing 400010, Peoples R China"

通信作者："Chen, T (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Radiol, Chongqing 400010, Peoples R China."

来源：BMC PULMONARY MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000882004300003

JCR分区：Q2

影响因子：3.1

年份：2022

卷号：22

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Meta-analysis; Clinical manifestations; Radiologic findings; Pulmonary cryptococcosis; Immunocompetent; Immunocompromised

摘要："Objective The purpose of our study was to perform a meta-analysis and systematic review to compare differences in clinical manifestations and chest computed tomography (CT) findings between immunocompetent and immunocompromised pulmonary cryptococcosis (PC) patients. Methods An extensive search for relevant studies was performed using the PubMed, EMBASE, Cochrane Library, and Web of Sciences databases from inception to September 30, 2021. We included studies that compared the clinical manifestations and chest CT findings between immunocompetent and immunocompromised PC patients. Study bias and quality assessment were performed using the Newcastle-Ottawa Scale (NOS). Results Nine studies involving 248 immunocompromised and 276 immunocompetent PC patients were included in our analysis. The NOS score of each eligible study was above 5, indicating moderate bias. The proportion of elderly patients (> = 60 years old) in the immunosuppressed group was significantly higher than that in the immunocompetent group (OR = 2.90, 95% CI (1.31-6.43), Z = 2.63, p = 0.01). Fever (OR = 7.10, 95% CI (3.84-13.12), Z = 6.25, p < 0.000) and headache (OR = 6.92, 95% CI (2.95-16.26), Z = 4.44, p < 0.000) were more common in immunosuppressed patients. According to thin-section CT findings, lesions were more frequently distributed in the upper lobe (OR = 1.90, 95% CI (1.07-3.37), Z = 2.2, p = 0.028) in immunocompromised individuals. The proportions of patients with cavity sign (OR = 5.11, 95% CI (2.96-8.83), Z = 5.86, p = 0.00), ground-glass attenuation (OR = 5.27, 95% CI (1.60-17.35), Z = 2.73, p = 0.01), and mediastinal lymph node enlargement (OR = 2.41, 95% CI (1.12-5.20), Z = 2.24, p = 0.03) were significantly higher in immunocompromised patients. Conclusion No significant differences in nonspecific respiratory symptoms were found between immunocompromised and immunocompetent PC patients. Nevertheless, fever and headache were more common in immunocompromised patients. Among the CT findings, cavity, ground-glass attenuation, and mediastinal lymph node enlargement were more common in immunocompromised individuals."

基金机构：Natural Science Foundation of Chongqing Science and Technology Bureau [cstc2021jcyj-msxmX0216]; Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau) [2022MSXM144]

基金资助正文："This work was supported by Natural Science Foundation of Chongqing Science and Technology Bureau (2021, cstc2021jcyj-msxmX0216). Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau) (2021, 2022MSXM144)."