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Risk Factors for Mortality in Patients With Novel Bunyavirus Infection: A Systematic Review and Meta-Analysis.
Shan Niu1, Xu Dong1, Yaqin Feng1
1Department of Infectious Disease, Hebei Medical University Third Hospital, Shi Jiazhuang, China.
Reviews in Medical Virology
|April 14, 2026
Summary
Novel bunyavirus infection has a 23% mortality rate. Key risk factors include older age, hemorrhagic manifestations, neurological symptoms, and elevated viral load, highlighting the need for further research.
Area of Science:
- Infectious Diseases
- Epidemiology
- Virology
Background:
- Novel bunyavirus infections present a significant public health threat due to unclear pathogenesis and rapid progression in severe cases.
- The case fatality rate associated with severe bunyavirus infections necessitates a thorough understanding of mortality predictors.
Purpose of the Study:
- To conduct a systematic review and meta-analysis to determine the overall mortality rate of novel bunyavirus infections.
- To identify and analyze significant risk factors associated with mortality in patients diagnosed with novel bunyavirus infection.
Main Methods:
- A comprehensive search of English and Chinese databases was performed up to April 2025.
- Inclusion criteria focused on original cohort or case-control studies reporting death as a clinical outcome in novel bunyavirus infection patients.
- Meta-analysis was conducted using R software (version 4.4.3) with the 'meta' and 'metafor' packages.
Main Results:
- The meta-analysis included 31 studies with 4682 patients, revealing a pooled mortality rate of 23% (95% CI: 20%-27%).
- Significant risk factors for mortality included advanced age (OR=1.06), hemorrhagic manifestations (OR=10.37), neurological symptoms (OR=6.04), consciousness disorders (OR=2.98), and elevated viral load (OR=2.42).
- Other identified risk factors comprised lower Glasgow Coma Scale scores (OR=0.76), prolonged Activated Partial Thromboplastin Time (OR=1.07) and Thrombin Time (OR=1.13), altered Haematocrit-Serum albumin levels (OR=1.14), and elevated liver enzymes (AST/ALT, OR=2.88) and LDH (OR=1.00).
Conclusions:
- This meta-analysis identifies several factors significantly associated with increased mortality in novel bunyavirus infections.
- The substantial heterogeneity observed across studies underscores the need for high-quality research to validate these findings and establish clinical consensus.
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