Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: A living systematic review [version 1; peer review: 2 approved].

Counotte, Michel Jacques; Meili, Kaspar Walter; Taghavi, Katayoun; Calvet, Guilherme; Sejvar, James; Low, Nicola (2019). Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: A living systematic review [version 1; peer review: 2 approved]. F1000Research, 8, p. 1433. F1000 Research Ltd 10.12688/f1000research.19918.1

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Background: The Zika virus (ZIKV) caused a large outbreak in the Americas leading to the declaration of a Public Health Emergency of International Concern in February 2016. A causal relation between infection and adverse congenital outcomes such as microcephaly was declared by the World Health Organization (WHO) informed by a systematic review structured according to a framework of ten dimensions of causality, based on the work of Bradford Hill. Subsequently, the evidence has continued to accumulate, which we incorporate in regular updates of the original work, rendering it a living systematic review. Methods: We present an update of our living systematic review on the causal relation between ZIKV infection and adverse congenital outcomes and between ZIKV and GBS for four dimensions of causality: strength of association, dose-response, specificity, and consistency. We assess the evidence published between January 18, 2017 and July 1, 2019. Results: We found that the strength of association between ZIKV infection and adverse outcomes from case-control studies differs according to whether exposure to ZIKV is assessed in the mother (OR 3.8, 95% CI: 1.7-8.7, I 2=19.8%) or the foetus/infant (OR 37.4, 95% CI: 11.0-127.1, I 2=0%). In cohort studies, the risk of congenital abnormalities was 3.5 times higher after ZIKV infection (95% CI: 0.9-13.5, I 2=0%). The strength of association between ZIKV infection and GBS was higher in studies that enrolled controls from hospital (OR: 55.8, 95% CI: 17.2-181.7, I 2=0%) than in studies that enrolled controls at random from the same community or household (OR: 2.0, 95% CI: 0.8-5.4, I 2=74.6%). In case-control studies, selection of controls from hospitals could have biased results. Conclusions: The conclusions that ZIKV infection causes adverse congenital outcomes and GBS are reinforced with the evidence published between January 18, 2017 and July 1, 2019.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Faculty Institutions > Teaching Staff, Faculty of Medicine

UniBE Contributor:

Counotte, Michel Jacques; Meili, Kaspar Walter; Taghavi, Katayoun and Low, Nicola

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2046-1402

Publisher:

F1000 Research Ltd

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

26 Nov 2019 15:29

Last Modified:

12 Dec 2019 15:25

Publisher DOI:

10.12688/f1000research.19918.1

PubMed ID:

31754425

Uncontrolled Keywords:

Disease outbreaks Guillain-Barré syndrome Zika arboviruses causality congenital abnormalities

BORIS DOI:

10.7892/boris.135618

URI:

https://boris.unibe.ch/id/eprint/135618

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