Clinical outcomes of hospitalized patients with chikungunya fever: A retrospective analysis
Lucas Lobo Mesquita1, Ênio Simas Macedo1, Sérgio Luiz Arruda Parente Filho1, Francisca Lillyan Christyan Nunes Beserra1, Evelyne Santana Girão2, Juliana Mandato Ferragut3, Roberto da Justa Pires Neto4, Geraldo Bezerra da Silva Júnior5, Elizabeth De Francesco Daher6
1 School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
2 Hospital Regional da Unimed, Fortaleza, Ceará, Brazil
3 Intensive Care Unit, Hospital São Carlos, Fortaleza, Ceará, Brazil
4 Department of Public Health, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
5 Public Health and Medical Sciences Post-Graduation Programs, School of Medicine, Health Sciences Center, University of Fortaleza, Fortaleza, Ceará, Brazil
6 Medical Sciences Post Graduate Program, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
Lucas Lobo Mesquita
School of Medicine, Federal University of Ceará, Fortaleza, Ceará
Source of Support: None, Conflict of Interest: None
Objective: To describe the prognostic and clinical profile of hospitalized patients with chikungunya virus (CHIKV) infection focusing on renal outcomes.
Methods: This is a cross-sectional study including all patients with confirmed chikungunya fever (CHIKF) admitted to 3 different high-complexity hospitals in Fortaleza, Brazil between January 2016 and June 2017. Data analysis was carried out to evaluate correlation between clinical profile and outcomes.
Results: Fifty-five patients were included, with a median age of 77 (IQR=21) years, and 23 (41.82%) were male. Twenty-five patients (45.45%, 25/55) developed acute kidney injury (AKI), and 15 (60.00%, 15/25) were classified as KDIGO 1, 1 (4.00%) as KDIGO 2, and 9 (36.00%) as KDIGO 3. The overall mortality was 34.54% whilst AKI-related mortality was 64.00% (16/25). Both AKI and encephalitis were associated with higher mortality. Patients who died were significantly older [82 (IQR=12) years vs. 70 (IQR= 28.75) years, P<0.001)]. In the multivariate analysis, abdominal pain was associated with an increased risk of severe AKI (OR=5.33, 95% CI=1.11–25.64, P=0.037) and AKI was an independent risk factor of death (OR=12.06, 95% CI=2.55–57.15, P=0.002). Recovery of renal function was similar among the different age groups.
Conclusions: AKI is present in half of the study population and is an independent risk factor of death. Thus, renal function should be carefully monitored in hospitalized patients with CHIKV infection.