Abstract：
BACKGROUND: Sudden non-cardiac death (SNCD) is a clinical entity comprising deaths lacking previous clinically significant symptoms, and in which the mechanisms of death do not involve the heart. Infection is a major cause of SNCD, particularly in children, and viruses are frequently involved in the disease process. Nevertheless, SNCD of viral infectious causes remains poorly characterized. Thus, a systematic review of the literature describing the association between viral infection and the development of SNCD was performed.
METHODS: PRISMA statement guidelines were followed in this systematic review. A literature search was conducted across MEDLINE, Scopus and Web of Science databases. Studies considered eligible were autopsy series or cohort studies of sudden death cases, in which evidence of viral disease as a cause of death was demonstrated, along with identification of causative agents.
RESULTS: Twelve studies published between 1996 and 2020 were included in this review. Selected studies were categorized into three groups according to the study population: infants and young children (up to four years of age); presumed sudden infant death syndrome patients; and older individuals (five years of age and older). SNCD with viral implication represents a minority of sudden death cases in all age groups, with infants and young children having a higher prevalence across studies. Respiratory infection was the main cause of viral SNCD, with influenza virus and respiratory syncytial virus being the most commonly identified agents in older individuals, and infants and young children respectively. Disseminated infection, gastrointestinal infection, and meningitis were other identified causes of SNCD in children.
CONCLUSIONS: No studies have directly assessed the frequency and causes of viral SNCD. Infants and young children show a considerable, but variable, prevalence of this clinical entity. Wider implementation of post-mortem virological molecular testing may help uncover previously unknown cases. More research into viral SNCD is needed, especially in the adult population.
METHODS: PRISMA statement guidelines were followed in this systematic review. A literature search was conducted across MEDLINE, Scopus and Web of Science databases. Studies considered eligible were autopsy series or cohort studies of sudden death cases, in which evidence of viral disease as a cause of death was demonstrated, along with identification of causative agents.
RESULTS: Twelve studies published between 1996 and 2020 were included in this review. Selected studies were categorized into three groups according to the study population: infants and young children (up to four years of age); presumed sudden infant death syndrome patients; and older individuals (five years of age and older). SNCD with viral implication represents a minority of sudden death cases in all age groups, with infants and young children having a higher prevalence across studies. Respiratory infection was the main cause of viral SNCD, with influenza virus and respiratory syncytial virus being the most commonly identified agents in older individuals, and infants and young children respectively. Disseminated infection, gastrointestinal infection, and meningitis were other identified causes of SNCD in children.
CONCLUSIONS: No studies have directly assessed the frequency and causes of viral SNCD. Infants and young children show a considerable, but variable, prevalence of this clinical entity. Wider implementation of post-mortem virological molecular testing may help uncover previously unknown cases. More research into viral SNCD is needed, especially in the adult population.
摘要：
背景：非心源性猝死（SNCD）是一种临床实体，包括先前缺乏临床显着症状的死亡，其中死亡机制与心脏无关。感染是SNCD的主要原因,特别是在儿童中，病毒经常参与疾病过程。然而，病毒感染原因的SNCD仍然缺乏表征。因此，我们对描述病毒感染与SNCD发展之间关联的文献进行了系统综述.
方法：本系统综述遵循PRISMA声明指南。在MEDLINE进行了文献检索，Scopus和WebofScience数据库。被认为合格的研究是猝死病例的尸检系列或队列研究，其中证明了病毒性疾病是死亡原因的证据，以及病原体的鉴定。
结果：本综述纳入了1996年至2020年发表的12项研究。根据研究人群将选定的研究分为三组：婴儿和幼儿（4岁以下）；假定的婴儿猝死综合征患者；和老年人（5岁及以上）。SNCD与病毒的影响代表了所有年龄组的少数猝死病例，在所有研究中，婴儿和幼儿的患病率较高。呼吸道感染是病毒性SNCD的主要病因,流感病毒和呼吸道合胞病毒是老年人中最常见的病原体，分别为婴儿和幼儿。播散性感染,胃肠道感染,脑膜炎是儿童SNCD的其他确定原因。
结论：没有研究直接评估病毒SNCD的频率和原因。婴幼儿表现出相当大的，但可变，这种临床实体的患病率。更广泛地实施死后病毒学分子检测可能有助于发现以前未知的病例。需要对病毒SNCD进行更多的研究，尤其是在成年人口中。
方法：本系统综述遵循PRISMA声明指南。在MEDLINE进行了文献检索，Scopus和WebofScience数据库。被认为合格的研究是猝死病例的尸检系列或队列研究，其中证明了病毒性疾病是死亡原因的证据，以及病原体的鉴定。
结果：本综述纳入了1996年至2020年发表的12项研究。根据研究人群将选定的研究分为三组：婴儿和幼儿（4岁以下）；假定的婴儿猝死综合征患者；和老年人（5岁及以上）。SNCD与病毒的影响代表了所有年龄组的少数猝死病例，在所有研究中，婴儿和幼儿的患病率较高。呼吸道感染是病毒性SNCD的主要病因,流感病毒和呼吸道合胞病毒是老年人中最常见的病原体，分别为婴儿和幼儿。播散性感染,胃肠道感染,脑膜炎是儿童SNCD的其他确定原因。
结论：没有研究直接评估病毒SNCD的频率和原因。婴幼儿表现出相当大的，但可变，这种临床实体的患病率。更广泛地实施死后病毒学分子检测可能有助于发现以前未知的病例。需要对病毒SNCD进行更多的研究，尤其是在成年人口中。
