Fatal Zika virus infection in the Americas: A systematic review

Abstract

Introduction: While death due to Zika virus (ZIKV) infection has been described, reports of fatal cases have been infrequent and no systematic reviews on the subject have been published. Methods: A systematic review of the literature in four databases was performed to assess fatal outcomes of postnatal ZIKV infection and the available evidence that links ZIKV infection to death. Results: Three hundred and eleven articles were retrieved; 20 of them were epidemiological reports from surveillance agencies and ministries of health. After screening by abstract and title, 59 articles were selected for full-text assessment. Of these, 35 were excluded (with reasons) and 24 were finally included for qualitative analysis. A total of 51 reported deaths associated with ZIKV infection in nine countries were identified. The majority of cases (56.9%) were not related to Guillain-Barré syndrome. Cases from three countries accounted for 67.6% of the deaths. ZIKV infection was laboratory-confirmed in the majority of cases (64.7%). Discussion: ZIKV was not considered to be a dangerous, and much less a lethal pathogen, until very recently. However, an increasing number of fatalities have been published in the literature since the first death was reported in 2016. Additional research is needed to elucidate factors that may mediate the pathogenesis of severe, atypical, and fatal disease.

Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis

“…Many of these reports have started to answer clinical questions, including evolution and outcomes, as well as potential risk factors, and clinical, laboratory and image findings; however, a systematic review to consolidate what has been learned from each study or reported case is to-date missing. Although systematic reviews and meta-analyses usually include randomized clinical trials (RCTs) and aim to provide a more precise estimate of the effect of a treatment or risk factor for disease, also have been extensively used, especially during the last decades, to synthesized observational studies [31][32][33]. In many situations, RCTs are not feasible or available, and only data from observational studies are accessible [33].…”

Clinical manifestations and health outcomes associated with Zika virus infections in adults: A systematic review

“…We compare this with a mean case fatality rate of 0.02% from ZIKV illustrated in a systematic review of ZIKV in the Americas. [128] In subjects with confirmed ZIKV and GBS, admission rate to the ICU was 50% and mortality rate was 3%. Consistent with our findings, Leonhard et al report in all cases, 49% admission rate to ICU and a mortality rate of 1%.…”

Introductory Chapter: Zika 2015-2020 - Knowledge and Experience in the Americas

“…However, the outbreak in Yap State "initiates" the events that would make ZIKV a potential pandemic threat and are briefly described in Figure 1. Other publications describe these milestones in more detail [13][14][15][16][17][18][19][20][21][22][23][24][25][26].…”