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Torres dos Santos Lopes D, Cerutti Junior C, Areias Cabidelle A, Espinosa Miranda A, Drumond Louro I, Pamplona de Góes Cavalcanti L, Vicente CR. Factors associated with hospitalization in the acute phase of Chikungunya. PLoS One 2023; 18:e0296131. [PMID: 38134205 PMCID: PMC10745164 DOI: 10.1371/journal.pone.0296131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE Determine characteristics associated with hospitalization in the acute phase of Chikungunya. METHODS Cross-sectional study including data on Chikungunya cases reported in Vitória, Espírito Santo state, Brazil, between March 2016 and December 2021. RESULTS Hospitalizations accounted for 1.42% (n = 41) of the 2,868 cases included. There were statistically significant differences between hospitalized and non-hospitalized regarding age (P 0.001), which was lower among hospitalized patients, and pregnancy, which was more frequent in the hospitalized group (P 0.010). Patients younger than two years old and older than 65 years corresponded to 31.7% of hospitalizations. Back pain (OR = 0.134; 95% CI = 0.044-0.409) and arthralgia (OR = 0.226; 95% CI = 0.083-0.613) were protective factors for hospitalization. CONCLUSION Groups at risk of severe Chikungunya, including those under two and over 65 years of age, may require more hospitalization, even with milder manifestations.
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Affiliation(s)
| | - Crispim Cerutti Junior
- Postgraduate Program in Infectious Disease, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
- Department of Social Medicine, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Aline Areias Cabidelle
- Health Surveillance Sector, Health Department of Vitória, Vitória, Espírito Santo, Brazil
| | - Angelica Espinosa Miranda
- Postgraduate Program in Infectious Disease, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
- Department of Social Medicine, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Iuri Drumond Louro
- Postgraduate Program in Biotechnology, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
- Department of Biology, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | | | - Creuza Rachel Vicente
- Postgraduate Program in Infectious Disease, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
- Department of Social Medicine, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
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Silva ADC, Silva ADC, de Castro PASV, Ávila IR, Bezerra JMT. Prevalence and epidemiological aspects of Chikungunya fever in states of the Northeast region of Brazil: A systematic review. Acta Trop 2023; 241:106872. [PMID: 36868369 DOI: 10.1016/j.actatropica.2023.106872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 03/05/2023]
Abstract
Chikungunya fever is a disease caused by the Chikungunya virus (CHIKV), which is transmitted through the bite of infected female hematophagous mosquitoes of the genus Aedes (Diptera: Culicidae). In the Americas, the first autochthonous cases of the disease were recorded in 2013. A year later, in 2014, the first records of the disease were acquired locally in Brazil, in the states of Bahia and Amapá. The present study aimed to carry out a systematic review of the literature on the prevalence and epidemiological aspects of Chikungunya fever in states of the Northeast region of Brazil, between the years 2018 to 2022. This study was registered in the Open Science Framework (OSF) and in the International Prospective Register of Systemactic Reviews (PROSPERO) and followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The searches were carried out in the scientific electronic databases Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), U. S. National Library of Medicine (PubMed) and Scientific Electronic Library Online (SciELO), using descriptors cataloged in Descritores em Ciências da Saúde (DeCS) and Medical Subject Headings (MeSH) in Portuguese, English and Spanish. Gray literature was also searched by accessing Google Scholar to search for additional publications not captured in the selected electronic databases. Of the 19 studies included in the present systematic review, seven referred to the state of Ceará. Most cases of Chikungunya fever corresponded to the female gender (ranging from 7.5% to 100.0%), to the age group younger than 60 years (84.2%), to literate individuals (93.3%), belonging to the non-white race/color (95.21%) and blacks (100.0%), and residents of the urban area (range from 51.95% to 100.0%). As for laboratory characteristics, most notifications were diagnosed using clinical-epidemiological criteria (ranging from 71.21% to 90.35%). The epidemiological information about Chikungunya fever in the Northeast region of Brazil presented in this systematic review is useful to better understand the characteristics of the disease introduction process in the country. To this end, prevention and control strategies must be adopted, especially in the Northeast, as this region is most responsible for the number of cases of the disease in the country.
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Affiliation(s)
- Aline do Carmo Silva
- Programa de Pós-Graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Estadual do Maranhão, São Luís, Maranhão, Brazil
| | - Alane do Carmo Silva
- Curso de Licenciatura em Ciências Biológicas, Universidade Estadual do Maranhão, Centro de Estudos Superiores de Lago da Pedra, Lago da Pedra, Maranhão, Brazil
| | - Pedro Alves Soares Vaz de Castro
- Curso de Bacharelado em Medicina, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Isabela Resende Ávila
- Programa de Pós-Graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Juliana Maria Trindade Bezerra
- Programa de Pós-Graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Estadual do Maranhão, São Luís, Maranhão, Brazil; Curso de Licenciatura em Ciências Biológicas, Universidade Estadual do Maranhão, Centro de Estudos Superiores de Lago da Pedra, Lago da Pedra, Maranhão, Brazil; Programa de Pós-Graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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3
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Cai L, Hu X, Liu S, Wang L, Lu H, Tu H, Huang X, Tong Y. The research progress of Chikungunya fever. Front Public Health 2023; 10:1095549. [PMID: 36699921 PMCID: PMC9870324 DOI: 10.3389/fpubh.2022.1095549] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/15/2022] [Indexed: 01/11/2023] Open
Abstract
Chikungunya fever, an acute infectious disease caused by Chikungunya virus (CHIKV), is transmitted by Aedes aegypti mosquitoes, with fever, rash, and joint pain as the main features. 1952, the first outbreak of Chikungunya fever was in Tanzania, Africa, and the virus was isolated in 1953. The epidemic has expanded from Africa to South Asia, the Indian Ocean islands and the Americas, and is now present in more than 100 countries and territories worldwide, causing approximately 1 million infections worldwide each year. In addition, fatal cases have been reported, making CHIKV a relevant public health disease. The evolution of the virus, globalization, and climate change may have contributed to the spread of CHIKV. 2005-2006 saw the most severe outbreak on Reunion Island, affecting nearly 35% of the population. Since 2005, cases of Chikungunya fever have spread mainly in tropical and subtropical regions, eventually reaching the Americas through the Caribbean island. Today, CHIKV is widely spread worldwide and is a global public health problem. In addition, the lack of a preventive vaccine and approved antiviral treatment makes CHIKV a major global health threat. In this review, we discuss the current knowledge on the pathogenesis of CHIKV, focusing on the atypical disease manifestations. We also provide an updated review of the current development of CHIKV vaccines. Overall, these aspects represent some of the most recent advances in our understanding of CHIKV pathogenesis and also provide important insights into the current development of CHIKV and potential CHIKV vaccines for current development and clinical trials.
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Affiliation(s)
- Li Cai
- Department of Infectious Disease Control and Prevention, Wuhan Center for Disease Control and Prevention, Wuhan, China,School of Public Health, Wuhan University, Wuhan, China
| | - Xinyi Hu
- Global Study Institute, University of Geneva, Geneva, Switzerland
| | - Shuang Liu
- Department of Infectious Disease Control and Prevention, Hubei Center for Disease Control and Prevention, Wuhan, China
| | - Lei Wang
- Department of Economic Management, China University of Geosciences, Wuhan, China
| | - Hao Lu
- Department of Infectious Disease Control and Prevention, Hubei Center for Disease Control and Prevention, Wuhan, China
| | - Hua Tu
- Department of Infectious Disease Control and Prevention, Hubei Center for Disease Control and Prevention, Wuhan, China
| | - Xibao Huang
- Department of Infectious Disease Control and Prevention, Hubei Center for Disease Control and Prevention, Wuhan, China,Xibao Huang ✉
| | - Yeqing Tong
- Department of Infectious Disease Control and Prevention, Hubei Center for Disease Control and Prevention, Wuhan, China,*Correspondence: Yeqing Tong ✉
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Costa DMDN, Gouveia PADC, Silva GEDB, Neves PDMDM, Vajgel G, Cavalcante MAGDM, Oliveira CBLD, Valente LM, Silveira VMD. The relationship between chikungunya virus and the kidneys: A scoping review. Rev Med Virol 2023; 33:e2357. [PMID: 35521644 DOI: 10.1002/rmv.2357] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/14/2022] [Accepted: 04/11/2022] [Indexed: 01/28/2023]
Abstract
Several atypical forms of chikungunya fever (CHIK) have been described, including neurological, cardiac and renal involvement. These forms may be related to high morbidity and mortality rates. This scoping review based on the PubMed, Scopus, and WOS databases aims to identify and summarise all the available evidence regarding the clinical and histopathological presentations and risk factors associated with kidney injury related to CHIK, as well as the clinical impact. Thus, a total of 54 papers were selected from 1606 initial references after applying the defined inclusion criteria. Data on the association between kidney injury and CHIK are scarce, with studies only conducted in the acute phase of the disease, lacking further characterisation. Kidney injury incidence in hospitalised patients using the Kidney Disease Improving Global Outcomes criteria varies from 21% to 45%, being higher among patients with atypical and severe manifestations. Although acute kidney injury does not seem to be related to viraemia, it may be related to higher mortality. Few studies have described the renal histopathological changes in the acute phase of CHIK, with prevalent findings of acute interstitial nephritis with mononuclear infiltrate, glomerular congestion and nephrosclerosis. Only one study assessed the kidney function of patients in the subacute and chronic phases of CHIK. Additionally, individuals with comorbidities, including chronic kidney disease, may be among those with a greater risk of presenting worse outcomes when affected by CHIK. The results described herein may contribute to better understand the relationship between the kidneys and chikungunya virus.
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Affiliation(s)
| | | | | | - Precil Diego Miranda de Menezes Neves
- Nephrology Division, University of São Paulo School of Medicine, São Paulo, Brazil.,Nephrology and Dialysis Center, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Gisele Vajgel
- Nephrology Division, Federal University of Pernambuco, Recife, Brazil
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Traverse EM, Millsapps EM, Underwood EC, Hopkins HK, Young M, Barr KL. Chikungunya Immunopathology as It Presents in Different Organ Systems. Viruses 2022; 14:v14081786. [PMID: 36016408 PMCID: PMC9414582 DOI: 10.3390/v14081786] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 12/13/2022] Open
Abstract
Chikungunya virus (CHIKV) is currently an urgent public health problem as high morbidity from the virus leaves populations with negative physical, social, and economic impacts. CHIKV has the potential to affect every organ of an individual, leaving patients with lifelong impairments which negatively affect their quality of life. In this review, we show the importance of CHIKV in research and public health by demonstrating the immunopathology of CHIKV as it presents in different organ systems. Papers used in this review were found on PubMed, using “chikungunya and [relevant organ system]”. There is a significant inflammatory response during CHIKV infection which affects several organ systems, such as the brain, heart, lungs, kidneys, skin, and joints, and the immune response to CHIKV in each organ system is unique. Whilst there is clinical evidence to suggest that serious complications can occur, there is ultimately a lack of understanding of how CHIKV can affect different organ systems. It is important for clinicians to understand the risks to their patients.
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de Morais Alves Barbosa Oliveira R, Kalline de Almeida Barreto F, Praça Pinto G, Timbó Queiroz I, Montenegro de Carvalho Araújo F, Wanderley Lopes K, Lúcia Sousa do Vale R, Rocha Queiroz Lemos D, Washington Cavalcante J, Machado Siqueira A, Carla Vinhal Frutuoso L, Carmen Duarte E, Silva Lima Neto A, Ricardo Ribas Freitas A, Pamplona de Góes Cavalcanti L. Chikungunya Death Risk Factors in Brazil, in 2017: A case-control study. PLoS One 2022; 17:e0260939. [PMID: 35389992 PMCID: PMC8989201 DOI: 10.1371/journal.pone.0260939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 11/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background In 2016/2017 we had a major epidemic of chikungunya (CHIK) in Brazil, with many deaths. We evaluated to factors associated with deaths from CHIK that occurred in the city of Fortaleza, Brazil. Methods A matched case-control study was conducted (1:2), by sex, age (± 5 years) and neighborhood. Cases were CHIK deaths that occurred between January 1 and December 31, 2017, in Fortaleza, Brazil, and which were laboratory confirmed. Controls were laboratory confirmed CHIK patients occurring in the same neighborhood and in the same period, but which did not progress to death. Results 82 cases of CHIK and 164 controls were included. Considering the clinical history, significant associations were found between other chronic heart diseases (OR 3.8; CI: 1.53–9.26) and chronic kidney disease (OR 12.77; CI: 2.75–59.4). In the multivariate analysis of the variables related to signs and symptoms, fever (OR: 19.23 CI: 1.73–213.78), abdominal pain (OR: 3; 74 CI: 1.06–13.16), apathy (OR: 11.62 CI: 2.95–45.82) and dyspnea (OR: 50.61; CI: 12.37–207.18) were identified with greater likelihood of death from CHIK. It also stood out that altered blood glucose was associated with cases with a worse prognosis (OR: 13.5; CI: 1.3–135.0). Among the laboratory findings, only lymphocytes and albumin were not associated with greater likelihood of death. Conclusion The factors related with deaths were chronic kidney disease and previous heart disease, presence of fever, abdominal pain, apathy, dyspnea and arthritis and laboratory findings such as leukocytosis, leukopenia, thrombocytopenia, neutropenia and lymphopenia.
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Affiliation(s)
| | | | | | | | | | | | | | | | - John Washington Cavalcante
- Programa de Pós-graduação em Patologia, Universidade Federal do Ceará, Fortaleza, CE, Brasil
- Serviço de Verificação de Óbitos Dr Rocha Furtado, Secretaria de Saúde do Estado do Ceará, Fortaleza, CE, Brasil
| | - André Machado Siqueira
- Instituto Nacional de Doenças Infecciosas da Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Lívia Carla Vinhal Frutuoso
- Universidade de Brasília, Programa de Pós-Graduação em Medicina Tropical, Brasília, DF, Brasil
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília, DF, Brasil
| | - Elisabeth Carmen Duarte
- Universidade de Brasília, Programa de Pós-Graduação em Medicina Tropical, Brasília, DF, Brasil
| | | | | | - Luciano Pamplona de Góes Cavalcanti
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal do Ceará, Fortaleza, CE, Brasil
- Faculdade de Medicina, Centro Universitário Christus, Fortaleza, CE, Brasil
- Programa de Pós-graduação em Patologia, Universidade Federal do Ceará, Fortaleza, CE, Brasil
- * E-mail:
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Archila ED, López LS, Castellanos JE, Calvo EP. Molecular and biological characterization of an Asian-American isolate of Chikungunya virus. PLoS One 2022; 17:e0266450. [PMID: 35385544 PMCID: PMC8985947 DOI: 10.1371/journal.pone.0266450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 03/21/2022] [Indexed: 11/18/2022] Open
Abstract
Chikungunya virus is an arthropod-transmitted virus that causes chikungunya fever, a disease characterized by severe muscle and joint pain. In 2013, the virus was introduced to the Americas and caused approximately 2.7 million cases of infection during the subsequent two years. The lack of knowledge regarding the biological behavior of the viral strains circulating during the outbreak motivated the characterization of an isolate from the Colombian outbreak, starting from analysis of the complete genome to the biological behavior in vitro. The full genome was retrieved using next-generation sequencing. The infective and replicative capacities were evaluated in HEK293T, Huh-7, and MRC-5 cell lines. The infection rates were determined by flow cytometry, and the cytopathic effect was assessed by a resazurin fluorescent metabolic assay. The viral yield was quantified using the virus plaque formation assay, while the viral proteins and genomic RNA kinetics were subsequently evaluated by western-blot and RT-qPCR. The COL7624 isolate clustered with other American and Caribbean sequences in the Asian American lineage. The T669A substitution in E2 protein distinguished it from other Colombian sequences reported in 2014. After 48 h post infection (hpi), the three cell lines analyzed reached infection percentages exceeding 65%, generating a high load of infectious viral progeny. The infection kinetics indicated that the replication peak of this CHIKV isolate is around 24 hpi, although gRNA is detectable in the culture supernatant from 4 hpi onwards. The infection caused the overexpression of interferon and pro-inflammatory cytokines, such as IL-1β, TNF-α, and IL-8. The COL7624 CHIKV isolate exhibited a high infective and replicative capacity as well as activation of cellular immune responses, similar to isolates belonging to the other genotypes.
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Affiliation(s)
- Edwin D. Archila
- Laboratorio de Virología, Universidad El Bosque, Bogotá D.C., Colombia
| | - Lady S. López
- Laboratorio de Virología, Universidad El Bosque, Bogotá D.C., Colombia
| | | | - Eliana P. Calvo
- Laboratorio de Virología, Universidad El Bosque, Bogotá D.C., Colombia
- * E-mail:
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Abstract
El virus de chikunguña (CHIKV) es un Alfavirus perteneciente al grupo denominado del Viejo Mundo; estos son virus artritogénicos que causan una enfermedad febril caracterizada por artralgias y mialgias. Aunque la muerte por CHIKV es poco frecuente, la enfermedad puede llegar a ser incapacitante y generar un amplio espectro de manifestaciones atípicas, como complicaciones cardiovasculares, respiratorias, oculares, renales y dérmicas, entre otras. Cuando el dolor articular persiste por tres o más meses, da lugar a la forma crónica de la enfermedad denominada reumatismo inflamatorio crónico poschikunguña, el cual es la principal secuela de la enfermedad. Se considera que este virus no es neurotrópico, sin embargo, puede afectar el sistema nervioso central y generar secuelas graves y permanentes, principalmente, en niños y ancianos. En África, Asia y Europa se habían reportado anteriormente brotes epidémicos por CHIKV, pero solo hasta finales del 2013 se documentó la introducción del virus a las Américas; desde entonces, el virus se ha propagado a 45 países o territorios del continente y el número de casos acumulados ascendió a cerca de dos millones en dos años. Esta revisión describe de manera general la biología molecular del virus, sus manifestaciones clínicas, su patogénesis y las principales complicaciones posteriores a la infección. Además, reúne la información de la epidemia en Colombia y el continente americano publicada entre el 2014 y el 2020.
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Cerbino-Neto J, Mesquita EC, Amancio RT, Brasil PEAAD. Events preceding death among chikungunya virus infected patients: a systematic review. Rev Soc Bras Med Trop 2020; 53:e04312019. [PMID: 32401863 PMCID: PMC7269536 DOI: 10.1590/0037-8682-0431-2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 03/24/2020] [Indexed: 12/20/2022] Open
Abstract
Since its re-emergence in the late 1990s, there have been reports of Chikungunya fever (CHIK-F) presenting with severe or atypical findings. There is little knowledge regarding the clinical events leading to the death of patients with CHIK-F. This study aimed to systematically review the literature regarding CHIK-F and identify clinical features preceding death. We searched PubMed, Scopus, Embase, Lilacs, and IsiWeb for case-reports, case-series, or cohorts of CHIK-F reporting at least one death, up to December 2019. Fifty-seven reports were analyzed, including 2140 deaths. Data about specific clinical events that precede death are scarce. The central tendency of time between disease onset and death ranged from 2 days to 150 days. The most common clinical findings among decedents were fever (22.0%), arthralgia (15.7%), myalgia (10.7%), and headache (8.2%). Excluding pediatric populations, the reported central tendency of age among the decedents was 53 or older, with a non-weighted median of 67, ranging up to 80 years old. Authors mentioned organic dysfunction in 91.2% reports. Among all the 2140 decedents, the most common dysfunctions were cardiovascular (7.2%), respiratory (6.4%), neurological (5.4%), renal (4.2%), liver (3.0%), and hematological (1.3%) dysfunction. Exacerbation of previous diabetes (5.6%) or hypertension (6.9%) was mentioned as conditions preceding death. Currently, older age, primary neurological, cardiovascular, or respiratory dysfunction and a previous diagnosis of diabetes or hypertension are the main clinical events preceding death.
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Affiliation(s)
- José Cerbino-Neto
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | - Rodrigo Teixeira Amancio
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
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