A Meta-Analysis Of Clinical Characteristics Of Infectious Mononucleosis In Children Infected With Epstein-Barr Virus Combined With Cytomegalovirus

Objective: To investigate the clinical characteristics of infectious mononucleosis in children infected with Epstein-Barr virus combined with cytomegalovirus and to further guide clinical diagnosis and treatment and prevent serious complications.Methods:Eight databases including CNKI,VIP Chinese Journal Database,Wanfang Database,China Biomedical Literature Database(CBM),Pub Med,Embase,Cochrane library and Web of Science were systematically collected.Literature on IM co-infection of Epstein-Barr virus and cytomegalovirus in children published from the self-established database to January 30,2023 was retrieved.Meta-analysis was performed using Rev Man 5.4 and Stata 15.1software.Results: A total of 9 studies was included,all of which were case-control studies.Meta-analysis showed that the clinical characteristics of infectious mononucleosis in children infected with Epstein-Barr virus combined with cytomegalovirus were as follows: duration of fever(MD=2.83,95%CI:2.28-3.38),hepatomegaly(RR=1.97,95%CI: 1.55-2.51),splenomegaly(RR=2.03,95%CI: 1.68-2.47),thrombocytopenia(RR=9.04,95%CI:3.65-22.35),anemia(RR=8.70,95%CI: 4.10-18.42),pneumonia(RR=3.20,95%CI: 2.35-4.35),percentage of atypical lymphocytes(MD=7.15,95%CI:5.33-8.98),abnormal liver function(RR=2.03,95%CI: 1.69-2.43),P<0.05 in the above studies,the differences were statistically significant.Age of onset(MD=-0.52,95%CI:-1.30-0.25),Length of hospital stay(MD=-0.15,95%CI:-0.73-0.43),gender(male: RR=0.94,95%CI: 0.81-1.09;Females: RR=1.09,95%CI: 0.90-1.33),lymph node enlargement(RR=1.04,95%CI: 0.93-1.16),angina(RR=1.04,95%CI: 0.95-1.13),rash(RR=1.34,95%CI: 0.73-2.44),CRP(RR=-0.30,95%CI:-2.91-2.31),ESR(RR=-1.18,95%CI:-6.27-3.92),leukocyte count(MD=-0.12,95%CI:-0.97-0.73),percentage of lymphocytes(MD=-0.26,95%CI:-3.05-2.53),P>0.05,the difference was not statistically significant.Conclusions:Based on existing research data,it was concluded that compared with the children only infected with Epstein-Barr virus,the children infected with Epstein-Barr virus combined with cytomegalovirus have the fever lasted longer,the incidence of liver enlargement and spleen enlargement were higher,the incidence of anemia and pneumonia was higher.In laboratory examination,the incidence of fewer platelets and abnormal liver function is higher and the percentage of heterogeneous lymphocytes was higher.The correlation between length of age of onset,gender of disease,hospital stay,lymph node enlargement,angina,rash,white blood cell count,percentage of lymphocytes,CRP,and ESR in children with mixed and simple infections has not been determined.It is helpful for medical workers to carry out more accurate diagnoses and treatments to carry out etiological detection and early identification of mixed pathogen infection in children with infectious mononucleosis.