{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T09:58:26Z","timestamp":1774951106100,"version":"3.50.1"},"reference-count":64,"publisher":"European Respiratory Society (ERS)","issue":"179","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir Rev"],"accepted":{"date-parts":[[2025,11,9]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>COPD is associated with an increased risk of infections, such as herpes zoster, potentially leading to greater morbidity and mortality. This systematic review assessed the evidence on herpes zoster burden in COPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A global systematic literature review and meta-analysis was conducted (MEDLINE\/Embase, 2003\u20132024) on herpes zoster burden (incidence, risk, complications, impact on COPD and healthcare resources) in adults aged \u226518\u2005years with COPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      22 studies on herpes zoster burden in COPD were included. The pooled herpes zoster incidence rate per 1000\u2005person-years in adults with COPD aged \u226518\u2005years was 10.98 (95% CI 8.28\u201314.56), increasing to 13.95 (10.80\u201318.02) in adults aged \u226550\u2005years. The pooled risk ratio of developing herpes zoster was 1.49 (1.17\u20131.89) in adults aged \u226518\u2005years with COPD and 1.86 (1.28\u20132.69) in COPD treated with corticosteroids. The pooled rate ratio of developing post-herpetic neuralgia (persistent pain lasting \u226590\u2005days) was 1.50 (1.10\u20132.04) in adults with herpes zoster and COPD\n                      <jats:italic>versus<\/jats:italic>\n                      with herpes zoster alone. Herpes zoster was linked to higher healthcare costs and resource use, and may be associated with COPD exacerbations. Study designs, settings, case definitions, sample sizes and study periods differed, resulting in heterogeneity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adults with COPD have an increased risk of herpes zoster and complications and an associated burden on healthcare systems, with higher risks in those on corticosteroids. Herpes zoster vaccines offer effective protection, including for adults with COPD, and could help reduce the disease and its economic burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/16000617.0167-2025","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T14:55:41Z","timestamp":1770216941000},"page":"250167","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Global herpes zoster burden in adults with COPD: a systematic review and meta-analysis"],"prefix":"10.1183","volume":"35","author":[{"given":"Alvaro A.","family":"Cruz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin J.","family":"Mortimer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid T.","family":"Sep\u00falveda-Pach\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilde","family":"Vroling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2437-3675","authenticated-orcid":false,"given":"Charles","family":"Williams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"81","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"2026033102050961000_35.179.250167.1","unstructured":"Global Initiative for Chronic Obstructive Lung Disease (GOLD) . Global strategy for prevention, diagnosis and management of COPD: 2024 Report. 2024. Date last accessed: 25 September 2024. https:\/\/goldcopd.org\/2024-gold-report\/"},{"key":"2026033102050961000_35.179.250167.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-069679"},{"key":"2026033102050961000_35.179.250167.3","unstructured":"World Health Organization (WHO) . Chronic Obstructive Pulmonary Disease (COPD) \u2013 Key Facts. 2023. Date last accessed: 25 September 2024. www.who.int\/news-room\/fact-sheets\/detail\/chronic-obstructive-pulmonary-disease-(copd)"},{"key":"2026033102050961000_35.179.250167.4","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00081409"},{"key":"2026033102050961000_35.179.250167.5","doi-asserted-by":"crossref","first-page":"2565","DOI":"10.2147\/COPD.S433326","article-title":"A long-term study of adverse outcomes associated with oral corticosteroid use in COPD","volume":"18","author":"Tse","year":"2023","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2026033102050961000_35.179.250167.6","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1007\/s40121-021-00567-8","article-title":"Meta-regression of herpes zoster incidence worldwide","volume":"11","author":"Curran","year":"2022","journal-title":"Infect Dis Ther"},{"key":"2026033102050961000_35.179.250167.7","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-8-37"},{"key":"2026033102050961000_35.179.250167.8","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1007\/s40121-021-00581-w","article-title":"A cross-sectional concept elicitation study to understand the impact of herpes zoster on patients\u2019 health-related quality of life","volume":"11","author":"Van Oorschot","year":"2022","journal-title":"Infect Dis Ther"},{"key":"2026033102050961000_35.179.250167.9","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1038\/s41541-023-00757-0","article-title":"Healthy ageing: herpes zoster infection and the role of zoster vaccination","volume":"8","author":"Curran","year":"2023","journal-title":"NPJ Vaccines"},{"key":"2026033102050961000_35.179.250167.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-004833"},{"key":"2026033102050961000_35.179.250167.11","doi-asserted-by":"crossref","first-page":"2666","DOI":"10.1017\/S0950268817001546","article-title":"A systematic review of varicella seroprevalence in European countries before universal childhood immunization: deriving incidence from seroprevalence data","volume":"145","author":"Bollaerts","year":"2017","journal-title":"Epidemiol Infect"},{"key":"2026033102050961000_35.179.250167.12","doi-asserted-by":"publisher","DOI":"10.1177\/003591576505800106"},{"key":"2026033102050961000_35.179.250167.13","doi-asserted-by":"crossref","first-page":"25151355221084535","DOI":"10.1177\/25151355221084535","article-title":"Global herpes zoster incidence, burden of disease, and vaccine availability: a narrative review","volume":"10","author":"Pan","year":"2022","journal-title":"Ther Adv Vaccines Immunother"},{"key":"2026033102050961000_35.179.250167.14","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa005"},{"key":"2026033102050961000_35.179.250167.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2017.10.009"},{"key":"2026033102050961000_35.179.250167.16","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1007\/s15010-023-02156-y","article-title":"Risk factors for herpes zoster infections: a systematic review and meta-analysis unveiling common trends and heterogeneity patterns","volume":"52","author":"Steinmann","year":"2024","journal-title":"Infection"},{"key":"2026033102050961000_35.179.250167.17","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00462-2024"},{"key":"2026033102050961000_35.179.250167.18","unstructured":"Higgins JPT Thomas J , Chandler J , et al. (eds). Cochrane Handbook for Systematic Reviews of Interventions version 6.4. Date last updated: August 2024. https:\/\/training.cochrane.org\/handbook"},{"key":"2026033102050961000_35.179.250167.19","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"2026033102050961000_35.179.250167.20","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"2026033102050961000_35.179.250167.21","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/22.6.1189"},{"key":"2026033102050961000_35.179.250167.22","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwaa167"},{"key":"2026033102050961000_35.179.250167.23","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn217"},{"key":"2026033102050961000_35.179.250167.24","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys147"},{"key":"2026033102050961000_35.179.250167.25","doi-asserted-by":"publisher","DOI":"10.4103\/2229-3485.167092"},{"key":"2026033102050961000_35.179.250167.26","doi-asserted-by":"publisher","DOI":"10.4161\/hv.28620"},{"key":"2026033102050961000_35.179.250167.27","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/S1576-9887(11)70013-9","article-title":"Hospitalizaciones por herpes z\u00f3ster en pacientes con enfermedades cr\u00f3nicas en Espa\u00f1a [Herpes zoster hospitalizations of patients with chronic illnesses in Spain, 1998\u20132004]","volume":"12","author":"Gil-Prieto","year":"2011","journal-title":"Vacunas"},{"key":"2026033102050961000_35.179.250167.28","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1186\/s12879-018-3121-x","article-title":"Risk and impact of herpes zoster among COPD patients: a population-based study, 2009\u20132014","volume":"18","author":"Mu\u00f1oz-Quiles","year":"2018","journal-title":"BMC Infect Dis"},{"key":"2026033102050961000_35.179.250167.29","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jinf.2018.04.004","article-title":"Impact of postherpetic neuralgia: a six year population-based analysis on people aged 50\u2005years or older","volume":"77","author":"Mu\u00f1oz-Quiles","year":"2018","journal-title":"J Infect"},{"key":"2026033102050961000_35.179.250167.30","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.arbres.2023.08.010","article-title":"Chronic respiratory diseases as a risk factor for herpes zoster infection","volume":"59","author":"Morena","year":"2023","journal-title":"Arch Bronconeumol"},{"key":"2026033102050961000_35.179.250167.31","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g2911"},{"key":"2026033102050961000_35.179.250167.32","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1212\/WNL.0000000000002808","article-title":"Quantification of risk factors for postherpetic neuralgia in herpes zoster patients: a cohort study","volume":"87","author":"Forbes","year":"2016","journal-title":"Neurology"},{"key":"2026033102050961000_35.179.250167.33","doi-asserted-by":"crossref","first-page":"5589","DOI":"10.1016\/j.vaccine.2017.08.065","article-title":"Prevaccination epidemiology of herpes zoster in Denmark: quantification of occurrence and risk factors","volume":"35","author":"Schmidt","year":"2017","journal-title":"Vaccine"},{"key":"2026033102050961000_35.179.250167.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2012.06.020"},{"key":"2026033102050961000_35.179.250167.35","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1007\/s13555-021-00535-7","article-title":"Burden of herpes zoster in adult patients with underlying conditions: analysis of German claims data, 2007\u20132018","volume":"11","author":"Batram","year":"2021","journal-title":"Dermatol Ther"},{"key":"2026033102050961000_35.179.250167.36","first-page":"66","article-title":"Patterns of prescription, hospitalizations and costs of herpes zoster in patients at risk, from a large Italian claims database","volume":"7","author":"Calabria","year":"2020","journal-title":"Glob Reg Health Technol Assess"},{"key":"2026033102050961000_35.179.250167.37","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s40121-023-00902-1","article-title":"Incidence and burden of herpes zoster in Sweden: a regional population-based register study","volume":"13","author":"S\u00f6dergren","year":"2024","journal-title":"Infect Dis Ther"},{"key":"2026033102050961000_35.179.250167.38","first-page":"502","article-title":"Increased health care resource utilization and costs associated with herpes zoster among patients aged","volume":"8","author":"Ghaswalla","year":"2021","journal-title":"Chronic Obstr Pulm Dis"},{"key":"2026033102050961000_35.179.250167.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2012.05.021"},{"key":"2026033102050961000_35.179.250167.40","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1016\/j.jaci.2015.10.032","article-title":"Asthma as a risk factor for zoster in adults: a population-based case\u2013control study","volume":"137","author":"Kwon","year":"2016","journal-title":"J Allergy Clin Immunol"},{"key":"2026033102050961000_35.179.250167.41","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001420"},{"key":"2026033102050961000_35.179.250167.42","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1111\/crj.13554","article-title":"Chronic obstructive pulmonary disease is associated with an increased risk of herpes zoster: a retrospective United States claims database analysis","volume":"16","author":"Thompson-Leduc","year":"2022","journal-title":"Clin Respir J"},{"key":"2026033102050961000_35.179.250167.43","doi-asserted-by":"crossref","first-page":"420","DOI":"10.3390\/vaccines10030420","article-title":"Knowledge and attitudes concerning herpes zoster among people with COPD: an interventional survey study","volume":"10","author":"Yawn","year":"2022","journal-title":"Vaccines"},{"key":"2026033102050961000_35.179.250167.44","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.jcjd.2017.10.060","article-title":"The prevalence and risk for herpes zoster infection in adult patients with diabetes mellitus in the Canadian Primary Care Sentinel Surveillance Network","volume":"42","author":"Queenan","year":"2018","journal-title":"Can J Diabetes"},{"key":"2026033102050961000_35.179.250167.45","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s13555-018-0268-8","article-title":"Burden of herpes zoster in the Japanese population with immunocompromised\/chronic disease conditions: results from a cohort study claims database from 2005\u20132014","volume":"9","author":"Imafuku","year":"2019","journal-title":"Dermatol Ther"},{"key":"2026033102050961000_35.179.250167.46","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1111\/1346-8138.15214","article-title":"Risk of herpes zoster in the Japanese population with immunocompromising and chronic disease conditions: results from a claims database cohort study, from 2005 to 2014","volume":"47","author":"Imafuku","year":"2020","journal-title":"J Dermatol"},{"key":"2026033102050961000_35.179.250167.47","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.101137"},{"key":"2026033102050961000_35.179.250167.48","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0059-2022"},{"key":"2026033102050961000_35.179.250167.49","first-page":"303","article-title":"Increased herpes zoster risk with inhaled corticosteroid use for those with chronic obstructive pulmonary disease","volume":"11","author":"Yawn","year":"2024","journal-title":"Chronic Obstr Pulm Dis"},{"key":"2026033102050961000_35.179.250167.50","doi-asserted-by":"crossref","first-page":"e177","DOI":"10.6061\/clinics\/2018\/e177","article-title":"Stroke risk among patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis","volume":"73","author":"Kim","year":"2018","journal-title":"Clinics"},{"key":"2026033102050961000_35.179.250167.51","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.amepre.2024.06.018","article-title":"Zoster vaccine lowers stroke and myocardial infarction risk in chronic disease","volume":"67","author":"Helm","year":"2024","journal-title":"Am J Prev Med"},{"key":"2026033102050961000_35.179.250167.52","unstructured":"Nair PA , Patel BC . Herpes Zoster. Treasure Island, StatPearls Publishing, 2023. Date last accessed 25 June 2025. www.ncbi.nlm.nih.gov\/books\/NBK441824\/"},{"key":"2026033102050961000_35.179.250167.53","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1093\/gerona\/gly150","article-title":"Quality of life impact of an adjuvanted recombinant zoster vaccine in adults aged 50\u2005years and older","volume":"74","author":"Curran","year":"2019","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2026033102050961000_35.179.250167.54","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000865"},{"key":"2026033102050961000_35.179.250167.55","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3390\/healthcare7010015","article-title":"Systematic review of pain in clinical practice guidelines for management of COPD: a case for including chronic pain?","volume":"7","author":"Lewthwaite","year":"2019","journal-title":"Healthcare"},{"key":"2026033102050961000_35.179.250167.56","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/all.70056","article-title":"Live zoster vaccination and the reduced risk of chronic respiratory diseases: an emulated target trial","volume":"81","author":"Kim","year":"2026","journal-title":"Allergy"},{"key":"2026033102050961000_35.179.250167.57","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200904-022RM"},{"key":"2026033102050961000_35.179.250167.58","doi-asserted-by":"crossref","first-page":"ofac485","DOI":"10.1093\/ofid\/ofac485","article-title":"Long-term protection against herpes zoster by the adjuvanted recombinant zoster vaccine: interim efficacy, immunogenicity, and safety results up to 10\u2005years after initial vaccination","volume":"9","author":"Strezova","year":"2022","journal-title":"Open Forum Infect Dis"},{"key":"2026033102050961000_35.179.250167.59","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603800"},{"key":"2026033102050961000_35.179.250167.60","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1501184"},{"key":"2026033102050961000_35.179.250167.61","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2019.1627818"},{"key":"2026033102050961000_35.179.250167.62","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2008.11.077"},{"key":"2026033102050961000_35.179.250167.63","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6703a5"},{"key":"2026033102050961000_35.179.250167.64","unstructured":"Robert Koch Institute (RKI) . Mitteilung der St\u00e4ndigen Impfkommission (STIKO) beim RKI. [Statement by the Standing Committee on Vaccination (STIKO) at the Robert Koch Institute: Scientific rationale for the recommendation of vaccination with the herpes zoster subunit vaccine]. 2025. Date last accessed: 17 December 2025. https:\/\/www.rki.de\/EN\/Topics\/Infectious-diseases\/Immunisation\/STIKO\/STIKO-recommendations\/Downloads\/04_25_english.pdf?__blob=publicationFile&v=2"}],"container-title":["European Respiratory Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/16000617.0167-2025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T09:05:30Z","timestamp":1774947930000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/16000617.0167-2025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":64,"journal-issue":{"issue":"179","published-online":{"date-parts":[[2026,2,4]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1183\/16000617.0167-2025"],"URL":"https:\/\/doi.org\/10.1183\/16000617.0167-2025","relation":{},"ISSN":["0905-9180","1600-0617"],"issn-type":[{"value":"0905-9180","type":"print"},{"value":"1600-0617","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}