{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T02:00:00Z","timestamp":1793325600308,"version":"4.5.0"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T00:00:00Z","timestamp":1717977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Reviews in Medical Virology"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Stroke is a common worldwide cause of death and disability, resulting from an obstruction or reduction in blood flow to the brain. Research has demonstrated that systemic infection such as herpes zoster (HZ) \/ ophthalmicus herpes zoster (HZO) can potentially trigger stroke. This study includes an updated systematic review and meta\u2010analysis of the epidemiologic data on the connection between HZ\/HZO infection and the risk of stroke. A meticulous search of different database yielded 905 studies. Furthermore, an additional 14 studies from a previous meta\u2010analysis were incorporated. Eligible studies underwent rigorous screening, resulting in 18 papers. Statistical analyses, including random\/fixed effects models and subgroup analyses, were conducted to assess pooled relative risk (RR) and heterogeneity. The meta\u2010analysis consisted of 5,505,885 participants and found a statistically significant association between HZ infection and the risk of stroke (pooled RR\u00a0=\u00a01.22, 95% confidence interval [CI] 1.12\u20131.34). The HZO infection showed a significantly higher overall pooled RR of 1.71 (95% CI 1.06\u20132.75), indicating a strong connection with the risk of stroke. Subgroup analysis revealed that the odds ratio might play a significant role in causing heterogeneity. Time since infection emerged as a crucial factor, with heightened stroke risk in the initial year post\u2010HZ\/HZO exposure, followed by a decline after the first year. Asian\/Non\u2010Asian studies demonstrated varied results in HZ\/HZO patients. Meta\u2010analysis reveals a significant HZ\/HZO\u2010stroke link. Subgroups highlight varied risks and warrant extended Asian\/non\u2010Asian patient investigation.<\/jats:p>","DOI":"10.1002\/rmv.2556","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T04:34:47Z","timestamp":1717994087000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["A comprehensive, updated systematic review and meta\u2010analysis of epidemiologic evidence on the connection between herpes zoster infection and the risk of stroke"],"prefix":"10.1002","volume":"34","author":[{"given":"Mohammad","family":"Heiat","sequence":"first","affiliation":[{"name":"Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL) Clinical Sciences Institute Baqiyatallah University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmood","family":"Salesi","sequence":"additional","affiliation":[{"name":"Chemical Injuries Research Center Systems Biology and Poisonings Institute Baqiyatallah University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0374-6547","authenticated-orcid":false,"given":"Mohammad Hossein","family":"Peypar","sequence":"additional","affiliation":[{"name":"Student Research Committee Baqiyatallah University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ramazani","sequence":"additional","affiliation":[{"name":"Student Research Committee Baqiyatallah University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdi","family":"Abdorrashidi","sequence":"additional","affiliation":[{"name":"Student Research Committee Baqiyatallah University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin Vesal","family":"Yeganeh","sequence":"additional","affiliation":[{"name":"Student Research Committee Baqiyatallah University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,10]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"StatPearls [Internet]","author":"Unnithan AKA","year":"2023"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/3238165"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/circresaha.116.308398"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.120.030429"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.110.608588"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2021.106274"},{"key":"e_1_2_11_8_1","volume-title":"StatPearls [Internet]","author":"Nair PA","year":"2023"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/ico.0000000000002754"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010015\u20101170\u2010y"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0000000000010028"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.117.006304"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8040547"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450\u2010200109000\u201000009"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392\u2010023\u201002291\u20104"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/b978\u20100\u201012\u2010819814\u20108.00015\u20109"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.22.4.348"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022\u2010510x(02)00021\u20107"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13365\u2010023\u201001144\u20100"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0206163"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.04.013"},{"key":"e_1_2_11_22_1","unstructured":"ROBINS\u2010E Development Group HigginsJ MorganR et\u00a0al.Risk of bias in non\u2010randomized studies \u2010 of exposure (ROBINS\u2010E). 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