Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil
ABSTRACT The Northeast of Brazil has experienced a triple epidemic, with the simultaneous circulation of dengue virus (DENV), chikungunya virus (CHIKV) and Zika virus (ZIKV), which may have contributed to the observed increase across this region of atypical forms of disease and deaths. In view of th...
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ftdoajarticles:oai:doaj.org/article:43e7672b92cb467dbb5476606d1d5cc4 2024-09-09T19:27:31+00:00 Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil Elaine Cristina Bomfim de Lima Ulisses Ramos Montarroyos Jurandy Júnior Ferraz de Magalhães George Santiago Dimech Heloísa Ramos Lacerda 2020-09-01T00:00:00Z https://doi.org/10.1590/s1678-9946202062069 https://doaj.org/article/43e7672b92cb467dbb5476606d1d5cc4 EN eng Universidade de São Paulo (USP) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652020000100232&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/s1678-9946202062069 https://doaj.org/article/43e7672b92cb467dbb5476606d1d5cc4 Revista do Instituto de Medicina Tropical de São Paulo, Vol 62 (2020) Neuroinvasive arboviruses Neurologic manifestations Log rank and survival Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2020 ftdoajarticles https://doi.org/10.1590/s1678-9946202062069 2024-08-05T17:49:30Z ABSTRACT The Northeast of Brazil has experienced a triple epidemic, with the simultaneous circulation of dengue virus (DENV), chikungunya virus (CHIKV) and Zika virus (ZIKV), which may have contributed to the observed increase across this region of atypical forms of disease and deaths. In view of this fact, non-congenital neurological disorders related to arboviruses were compared with other etiologies, mortality and survival rates of patients admitted to referral neurology hospitals in Pernambuco State, Northeast Brazil, from 2015 to 2018. Blood and cerebrospinal fluid samples were collected and tested using molecular and serological assays. The arbovirus-exposed groups were compared with respect to epidemiological, clinical and neurologic characteristics by using the Pearson’s chi-square test. For the survival analysis, the Kaplan-Meier and Hazard Ratio (HR) tests were used, with a 95% confidence interval (CI). Encephalitis and encephalomyelitis were more frequent in arboviruses, while myelitis predominated in the neurological disorders of other etiologies. Guillain-Barré Syndrome (GBS) was similarly distributed amongst the groups. Exposure to one of the arboviruses caused a six-fold increase in the risk of death (HR: 6.37; CI: 2.91 - 13.9). Amongst the arbovirus-exposed groups, infection (DENV/CHIKV) increased nine times the risk of death (HR: 9.07; CI: 3.67 - 22.4). The survival curve indicates that have been exposed to some arbovirus decreased the likelihood of survival compared to those with other etiologies (Log-Rank: p<0.001). Within this scenario, neurologic manifestations of DENV, CHIKV and ZIKV have the potential to increase mortality and decrease survival, and concomitant infection (DENV/CHIKV) is an aggravating factor in reducing the likelihood of survival when compared to monoinfections. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Barré ENVELOPE(-68.550,-68.550,-67.500,-67.500) Meier ENVELOPE(-45.900,-45.900,-60.633,-60.633) Revista do Instituto de Medicina Tropical de São Paulo 62 |
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Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Neuroinvasive arboviruses Neurologic manifestations Log rank and survival Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Neuroinvasive arboviruses Neurologic manifestations Log rank and survival Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Elaine Cristina Bomfim de Lima Ulisses Ramos Montarroyos Jurandy Júnior Ferraz de Magalhães George Santiago Dimech Heloísa Ramos Lacerda Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil |
topic_facet |
Neuroinvasive arboviruses Neurologic manifestations Log rank and survival Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
ABSTRACT The Northeast of Brazil has experienced a triple epidemic, with the simultaneous circulation of dengue virus (DENV), chikungunya virus (CHIKV) and Zika virus (ZIKV), which may have contributed to the observed increase across this region of atypical forms of disease and deaths. In view of this fact, non-congenital neurological disorders related to arboviruses were compared with other etiologies, mortality and survival rates of patients admitted to referral neurology hospitals in Pernambuco State, Northeast Brazil, from 2015 to 2018. Blood and cerebrospinal fluid samples were collected and tested using molecular and serological assays. The arbovirus-exposed groups were compared with respect to epidemiological, clinical and neurologic characteristics by using the Pearson’s chi-square test. For the survival analysis, the Kaplan-Meier and Hazard Ratio (HR) tests were used, with a 95% confidence interval (CI). Encephalitis and encephalomyelitis were more frequent in arboviruses, while myelitis predominated in the neurological disorders of other etiologies. Guillain-Barré Syndrome (GBS) was similarly distributed amongst the groups. Exposure to one of the arboviruses caused a six-fold increase in the risk of death (HR: 6.37; CI: 2.91 - 13.9). Amongst the arbovirus-exposed groups, infection (DENV/CHIKV) increased nine times the risk of death (HR: 9.07; CI: 3.67 - 22.4). The survival curve indicates that have been exposed to some arbovirus decreased the likelihood of survival compared to those with other etiologies (Log-Rank: p<0.001). Within this scenario, neurologic manifestations of DENV, CHIKV and ZIKV have the potential to increase mortality and decrease survival, and concomitant infection (DENV/CHIKV) is an aggravating factor in reducing the likelihood of survival when compared to monoinfections. |
format |
Article in Journal/Newspaper |
author |
Elaine Cristina Bomfim de Lima Ulisses Ramos Montarroyos Jurandy Júnior Ferraz de Magalhães George Santiago Dimech Heloísa Ramos Lacerda |
author_facet |
Elaine Cristina Bomfim de Lima Ulisses Ramos Montarroyos Jurandy Júnior Ferraz de Magalhães George Santiago Dimech Heloísa Ramos Lacerda |
author_sort |
Elaine Cristina Bomfim de Lima |
title |
Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil |
title_short |
Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil |
title_full |
Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil |
title_fullStr |
Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil |
title_full_unstemmed |
Survival analysis in non-congenital neurological disorders related to dengue, chikungunya and Zika virus infections in Northeast Brazil |
title_sort |
survival analysis in non-congenital neurological disorders related to dengue, chikungunya and zika virus infections in northeast brazil |
publisher |
Universidade de São Paulo (USP) |
publishDate |
2020 |
url |
https://doi.org/10.1590/s1678-9946202062069 https://doaj.org/article/43e7672b92cb467dbb5476606d1d5cc4 |
long_lat |
ENVELOPE(-68.550,-68.550,-67.500,-67.500) ENVELOPE(-45.900,-45.900,-60.633,-60.633) |
geographic |
Arctic Barré Meier |
geographic_facet |
Arctic Barré Meier |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista do Instituto de Medicina Tropical de São Paulo, Vol 62 (2020) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652020000100232&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/s1678-9946202062069 https://doaj.org/article/43e7672b92cb467dbb5476606d1d5cc4 |
op_doi |
https://doi.org/10.1590/s1678-9946202062069 |
container_title |
Revista do Instituto de Medicina Tropical de São Paulo |
container_volume |
62 |
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1809896947806371840 |