Seroprevalence of Enterovirus D68 Infection among Humans: A Systematic Review and Meta-Analysis

Yingying Shi, Qinqin Ran, Xiaochen Wang, Lu Shi

Human enterovirus D68 (EV-D68), which belongs to enteroviruses of the small RNA family, is a type of enterovirus that can cause acute respiratory tract infection and central nervous system diseases. This study systematically analysed and summarized EV-D68 antibody studies in databases and identified the seropositivity rates of different regions, ages, and sexes. Meta-analysis was performed using STATA 16.0 software. I2 and Q tests were used to analyse the heterogeneity of the included studies. Meta-regression analysis was performed for different groups, and Egger's linear regression analysis was used to evaluate publication bias. The results of multiple studies indicated that the serological prevalence range of EV-D68 antibody was 17.78%-96.69%. The results of the meta-analysis showed that the seropositivity rate of EV-D68 antibody was 76% (95% CI: 67%-84%), among which that of the Chinese population was 74% (95% CI: 61%-86%) and that of other countries was 79% (95% CI: 65%-91%). At the same time, a subgroup analysis was conducted. The seroprevalence of EV-D68 antibody was related to age but not sex or region. The seropositivity rate was lower in the below 5 years age group; however, it gradually increased with age. The results of this study showed that EV-D68 infection was widespread in the population, and the current clinical infection situation could not reflect the actual epidemic situation of the virus, among which children under 5 years old were vulnerable to infection, which should be given greater attention for epidemic prevention and control.