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Wongtrakul W, Charatcharoenwitthaya K, Karaketklang K, Charatcharoenwitthaya P. Incidence of acute liver failure and its associated mortality in patients with dengue infection: A systematic review and meta-analysis. J Infect Public Health 2024; 17:102497. [PMID: 39024894 DOI: 10.1016/j.jiph.2024.102497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/27/2024] [Accepted: 07/09/2024] [Indexed: 07/20/2024] Open
Abstract
Acute liver failure (ALF) is a devastating consequence of dengue infection. This systematic review and meta-analysis assessed the incidence of ALF in dengue infection and its associated mortality. We systematically searched the EMBASE and MEDLINE databases from inception to December 2023 for observational studies reporting ALF incidence and mortality in dengue patients. Twenty-one studies encompassing 26,839 dengue-infected patients were included. Meta-analysis revealed a pooled incidence of ALF in cases of general dengue infection of 2.0 % (95 % CI, 1.2-3.0 %), with 1.2 % (95 % CI, 0.6-2.1 %) in adults and 5.0 % (95 % CI, 1.5-10.2 %) in children. ALF incidence was 17.3 % (95 % CI, 6.5 %-31.5 %) in severe dengue and 7.4 % (95 % CI, 0.8-18.5 %) in dengue shock syndrome. The pooled mortality rate of dengue-associated ALF was 47.0 % (95 % CI, 32.9-61.2 %). These findings underscore the detrimental impact of dengue infection on the development of the relatively uncommon, albeit life-threatening, condition of ALF.
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Affiliation(s)
- Wasit Wongtrakul
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Khemajira Karaketklang
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Phunchai Charatcharoenwitthaya
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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2
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Lu HZ, Xie YZ, Gao C, Wang Y, Liu TT, Wu XZ, Dai F, Wang DQ, Deng SQ. Diabetes mellitus as a risk factor for severe dengue fever and West Nile fever: A meta-analysis. PLoS Negl Trop Dis 2024; 18:e0012217. [PMID: 38820529 PMCID: PMC11168630 DOI: 10.1371/journal.pntd.0012217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 06/12/2024] [Accepted: 05/14/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Dengue fever (DF) and West Nile fever (WNF) have become endemic worldwide in the last two decades. Studies suggest that individuals with diabetes mellitus (DM) are at a higher risk of developing severe complications from these diseases. Identifying the factors associated with a severe clinical presentation is crucial, as prompt treatment is essential to prevent complications and fatalities. This article aims to summarize and assess the published evidence regarding the link between DM and the risk of severe clinical manifestations in cases of DF and WNF. METHODOLOGY/PRINCIPAL FINDINGS A systematic search was conducted using the PubMed and Web of Science databases. 27 studies (19 on DF, 8 on WNF) involving 342,873 laboratory-confirmed patients were included in the analysis. The analysis showed that a diagnosis of DM was associated with an increased risk for severe clinical presentations of both DF (OR 3.39; 95% CI: 2.46, 4.68) and WNF (OR 2.89; 95% CI: 1.89, 4.41). DM also significantly increased the risk of death from both diseases (DF: OR 1.95; 95% CI: 1.09, 3.52; WNF: OR 1.74; 95% CI: 1.40, 2.17). CONCLUSIONS/SIGNIFICANCE This study provides strong evidence supporting the association between DM and an increased risk of severe clinical manifestations in cases of DF and WNF. Diabetic individuals in DF or WNF endemic areas should be closely monitored when presenting with febrile symptoms due to their higher susceptibility to severe disease. Early detection and appropriate management strategies are crucial in reducing the morbidity and mortality rates associated with DF and WNF in diabetic patients. Tailored care and targeted public health interventions are needed to address this at-risk population. Further research is required to understand the underlying mechanisms and develop effective preventive and therapeutic approaches.
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Affiliation(s)
- Hong-Zheng Lu
- Department of Pathogen Biology, Anhui Province Key Laboratory of Zoonoses, the Key Laboratory of Zoonoses of High Institutions in Anhui, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui China
| | - Yu-Zhuang Xie
- Department of Pathogen Biology, Anhui Province Key Laboratory of Zoonoses, the Key Laboratory of Zoonoses of High Institutions in Anhui, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Chen Gao
- Department of Pathogen Biology, Anhui Province Key Laboratory of Zoonoses, the Key Laboratory of Zoonoses of High Institutions in Anhui, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui China
| | - Ying Wang
- Department of Tropical Medicine, College of Military Preventive Medicine, Army Medical University, Chongqing, China
| | - Ting-Ting Liu
- Department of Tropical Medicine, College of Military Preventive Medicine, Army Medical University, Chongqing, China
| | - Xing-Zhe Wu
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Fang Dai
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Duo-Quan Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology; WHO Collaborating Center for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai, China
| | - Sheng-Qun Deng
- Department of Pathogen Biology, Anhui Province Key Laboratory of Zoonoses, the Key Laboratory of Zoonoses of High Institutions in Anhui, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
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Guimarães LM, Cunha GMD, Leite IDC, Moreira RI, Carneiro ELNDC. [Association between schooling and mortality rate from dengue in Brazil]. CAD SAUDE PUBLICA 2023; 39:e00215122. [PMID: 37792819 PMCID: PMC10552812 DOI: 10.1590/0102-311xpt215122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 10/06/2023] Open
Abstract
Dengue may be associated with individual level variables, such as schooling, increasing the risk of illness. The objective of this study is to analyze the disparities in dengue mortality among the least and the most educated in Brazil, from 2010 to 2018. This is a retrospective ecological study of the differences in the mortality rate due to dengue between the less and the more educated people in Brazil, according to the mortality rates due to general dengue, by age, sex, and Federative Unit (UF). A bootstrap and multiple imputation procedure for the variable schooling was implemented to consider the multilevel structure of the data from each UF over the years. For each aggregate bank generated, a multilevel Poisson model was adjusted. The improvement in the education level of the Brazilian population did not reflect on the decrease in mortality from dengue. There was an increase in the mortality rate from dengue in Brazil and an increase in the difference in mortality rates between less and more educated. Regardless of the imputation process, the results showed higher mortality rates from dengue among the less educated. Low schooling affected younger people more pronouncedly.
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Affiliation(s)
| | | | - Iuri da Costa Leite
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Ronaldo Ismerio Moreira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Ulasi II, Burdmann EA, Ijoma CK, Chou LF, Yang CW. Neglected and Emerging Infections of The Kidney. Semin Nephrol 2023; 43:151472. [PMID: 38216373 DOI: 10.1016/j.semnephrol.2023.151472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
Individuals, societies, and the environment are affected by neglected and emerging diseases. These diseases result in a variety of severe outcomes, including permanent disabilities, chronic diseases such as chronic kidney disease, and even mortality. Consequences include high health care expenditures, loss of means of support, social stigma, and social exclusion. The burden of these diseases is exacerbated in low- and middle-income countries owing to poverty, inadequate fundamental infrastructure, and the absence of health and social protection systems. The World Health Organization is committed to promoting the following public health strategies to prevent and control neglected tropical diseases: preventive chemotherapy; intensive case management; vector control; provision of safe drinkable water, sanitation, and hygiene; and veterinary public health. In addition, it promotes a One Health strategy, which is a collaborative, multisectoral, and interdisciplinary approach to achieving the greatest health outcomes by recognizing the interdependence of human beings, animals, plants, and their shared environment. This article provides knowledge and strategies for the prevention and treatment of neglected and emerging diseases, with a particular concentration on kidney diseases, as part of a comprehensive approach to One Health.
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Affiliation(s)
- Ifeoma I Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria-University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria; Renal Unit, Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - Emmanuel A Burdmann
- Laboratório de Investigação Médica (LIM 12), Faculdade de Medicina da Universidade de So Paulo, So Paulo, Brazil
| | - Chinwuba K Ijoma
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria-University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Li-Fang Chou
- Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chih-Wei Yang
- Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Huits R, Angelo KM, Amatya B, Barkati S, Barnett ED, Bottieau E, Emetulu H, Epelboin L, Eperon G, Medebb L, Gobbi F, Grobusch MP, Itani O, Jordan S, Kelly P, Leder K, Díaz-Menéndez M, Okumura N, Rizwan A, Rothe C, Saio M, Waggoner J, Yoshimura Y, Libman M, Hamer DH, Schwartz E. Clinical Characteristics and Outcomes Among Travelers With Severe Dengue : A GeoSentinel Analysis. Ann Intern Med 2023; 176:940-948. [PMID: 37335991 PMCID: PMC10760980 DOI: 10.7326/m23-0721] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Dengue virus is a flavivirus transmitted by Aedes mosquitoes and is an important cause of illness worldwide. Data on the severity of travel-associated dengue illness are limited. OBJECTIVE To describe the epidemiology, clinical characteristics, and outcomes among international travelers with severe dengue or dengue with warning signs as defined by the 2009 World Health Organization classification (that is, complicated dengue). DESIGN Retrospective chart review and analysis of travelers with complicated dengue reported to GeoSentinel from January 2007 through July 2022. SETTING 20 of 71 international GeoSentinel sites. PATIENTS Returning travelers with complicated dengue. MEASUREMENTS Routinely collected surveillance data plus chart review with abstraction of clinical information using predefined grading criteria to characterize the manifestations of complicated dengue. RESULTS Of 5958 patients with dengue, 95 (2%) had complicated dengue. Eighty-six (91%) patients had a supplemental questionnaire completed. Eighty-five of 86 (99%) patients had warning signs, and 27 (31%) were classified as severe. Median age was 34 years (range, 8 to 91 years); 48 (56%) were female. Patients acquired dengue most frequently in the Caribbean (n = 27 [31%]) and Southeast Asia (n = 21 [24%]). Frequent reasons for travel were tourism (46%) and visiting friends and relatives (32%). Twenty-one of 84 (25%) patients had comorbidities. Seventy-eight (91%) patients were hospitalized. One patient died of nondengue-related illnesses. Common laboratory findings and signs were thrombocytopenia (78%), elevated aminotransferase (62%), bleeding (52%), and plasma leakage (20%). Among severe cases, ophthalmologic pathology (n = 3), severe liver disease (n = 3), myocarditis (n = 2), and neurologic symptoms (n = 2) were reported. Of 44 patients with serologic data, 32 confirmed cases were classified as primary dengue (IgM+/IgG-) and 12 as secondary (IgM-/IgG+) dengue. LIMITATIONS Data for some variables could not be retrieved by chart review for some patients. The generalizability of our observations may be limited. CONCLUSION Complicated dengue is relatively rare in travelers. Clinicians should monitor patients with dengue closely for warning signs that may indicate progression to severe disease. Risk factors for developing complications of dengue in travelers need further prospective study. PRIMARY FUNDING SOURCE Centers for Disease Control and Prevention, International Society of Travel Medicine, Public Health Agency of Canada, and GeoSentinel Foundation.
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Affiliation(s)
- Ralph Huits
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy (R.H.)
| | - Kristina M Angelo
- Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia (K.M.A.)
| | - Bhawana Amatya
- CIWEC Hospital and Travel Medicine Center, Kathmandu, Nepal (B.A.)
| | - Sapha Barkati
- J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Quebec, Canada (S.B.)
| | - Elizabeth D Barnett
- Section of Pediatric Infectious Diseases, Boston Medical Center, Boston, Massachusetts (E.D.B., M.L.)
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium (E.B.)
| | - Hannah Emetulu
- International Society of Travel Medicine, Atlanta, Georgia (H.E., A.R.)
| | - Loïc Epelboin
- Infectious and Tropical Diseases Unit and CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana (L.E.)
| | - Gilles Eperon
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland (G.E.)
| | - Line Medebb
- Aix Marseille University, AP-HM, IHU-Méditerranée Infection, Marseille, France (L.M.)
| | - Federico Gobbi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, and Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy (F.G.)
| | - Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Center, Amsterdam, the Netherlands (M.P.G.)
| | - Oula Itani
- Institut Pasteur, Centre Médical, Centre d'Infectiologie Necker-Pasteur, Paris, France (O.I.)
| | - Sabine Jordan
- Division of Tropical Medicine, I. Department of Medicine, University Medical Center Hamburg-Eppendorf, and Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (S.J.)
| | - Paul Kelly
- BronxCare Hospital Center, Bronx, New York (P.K.)
| | - Karin Leder
- School of Public Health and Preventive Medicine, Monash University, and Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Victoria, Australia (K.L.)
| | - Marta Díaz-Menéndez
- Tropical Medicine Department, Hospital Universitario La Paz-Carlos III, IdIPAz, and CIBERINFECT, Madrid, Spain (M.D.)
| | - Nobumasa Okumura
- Center Hospital of the National Center for Global Health and Medicine, Shinjuku City, Tokyo, Japan (N.O.)
| | - Aisha Rizwan
- International Society of Travel Medicine, Atlanta, Georgia (H.E., A.R.)
| | - Camilla Rothe
- Department of Infectious Diseases and Tropical Medicine, Ludwig-Maximilians-Universität München, Munich, Germany (C.R.)
| | - Mauro Saio
- Doctor's Plaza, Nairobi Hospital, Nairobi, Kenya (M.S.)
| | - Jesse Waggoner
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia (J.W.)
| | | | - Michael Libman
- Section of Pediatric Infectious Diseases, Boston Medical Center, Boston, Massachusetts (E.D.B., M.L.)
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, Section of Infectious Diseases, Boston University School of Medicine, Center for Emerging Infectious Disease Policy and Research, Boston University, and National Emerging Infectious Disease Laboratory, Boston, Massachusetts (D.H.H.)
| | - Eli Schwartz
- The Center of Geographical Medicine and Tropical Diseases, Sheba Medical Center, Tel HaShomer, and Ramat Gan & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (E.S.)
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Annan E, Nguyen USDT, Treviño J, Wan Yaacob WF, Mangla S, Pathak AK, Nandy R, Haque U. Moderation effects of serotype on dengue severity across pregnancy status in Mexico. BMC Infect Dis 2023; 23:147. [PMID: 36899304 PMCID: PMC9999597 DOI: 10.1186/s12879-023-08051-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/02/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Pregnancy increases a woman's risk of severe dengue. To the best of our knowledge, the moderation effect of the dengue serotype among pregnant women has not been studied in Mexico. This study explores how pregnancy interacted with the dengue serotype from 2012 to 2020 in Mexico. METHOD Information from 2469 notifying health units in Mexican municipalities was used for this cross-sectional analysis. Multiple logistic regression with interaction effects was chosen as the final model and sensitivity analysis was done to assess potential exposure misclassification of pregnancy status. RESULTS Pregnant women were found to have higher odds of severe dengue [1.50 (95% CI 1.41, 1.59)]. The odds of dengue severity varied for pregnant women with DENV-1 [1.45, (95% CI 1.21, 1.74)], DENV-2 [1.33, (95% CI 1.18, 1.53)] and DENV-4 [3.78, (95% CI 1.14, 12.59)]. While the odds of severe dengue were generally higher for pregnant women compared with non-pregnant women with DENV-1 and DENV-2, the odds of disease severity were much higher for those infected with the DENV-4 serotype. CONCLUSION The effect of pregnancy on severe dengue is moderated by the dengue serotype. Future studies on genetic diversification may potentially elucidate this serotype-specific effect among pregnant women in Mexico.
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Affiliation(s)
- Esther Annan
- Department of Biostatistics & Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA. .,Center for Health and Wellbeing, School of Public and International Affairs, Princeton University, Princeton, NJ, USA.
| | - Uyen-Sa D T Nguyen
- Department of Biostatistics & Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Jesús Treviño
- Department of Urban Affairs at the School of Architecture, Universidad Autónoma de Nuevo León, 66455, San Nicolás de los Garza, Nuevo Léon, México
| | - Wan Fairos Wan Yaacob
- Mathematical Sciences Studies, College of Computing, Informatics and Media, Universiti Teknologi MARA Cawangan Kelantan, Lembah Sireh, Kampus Kota Bharu, 15150, Kota Bharu, Kelantan, Malaysia.,Institute for Big Data Analytics and Artificial Intelligence (IBDAAI), Universiti Teknologi MARA, Kompleks Al- Hawarizmi, 40450, Shah Alam, Selangor, Malaysia
| | - Sherry Mangla
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Ashok Kumar Pathak
- Department of Mathematics and Statistics, Central University of Punjab, Bathinda, Punjab, 151401, India
| | - Rajesh Nandy
- Department of Biostatistics & Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Ubydul Haque
- Rutgers Global Health Institute, New Brunswick, NJ, USA.,Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA
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Hospital admissions with influenza and impact of age and comorbidities on severe clinical outcomes in Brazil and Mexico. PLoS One 2022; 17:e0273837. [DOI: 10.1371/journal.pone.0273837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/17/2022] [Indexed: 11/12/2022] Open
Abstract
Background
The risk of hospitalization or death after influenza infection is higher at the extremes of age and in individuals with comorbidities. We estimated the number of hospitalizations with influenza and characterized the cumulative risk of comorbidities and age on severe outcomes in Mexico and Brazil.
Methods
We used national hospital discharge data from Brazil (SIH/SUS) from 2010–2018 and Mexico (SAEH) from 2010–2017 to estimate the number of influenza admissions using ICD-10 discharge codes, stratified by age (0–4, 5–17, 18–49, 50–64, and ≥65 years). Duration of hospital stay, admission to the intensive care unit (ICU), and in-hospital case fatality rates (CFRs) defined the severe outcomes. Rates were compared between patients with or without pre-specified comorbidities and by age.
Results
A total of 327,572 admissions with influenza were recorded in Brazil and 20,613 in Mexico, with peaks period most years. In Brazil, the median hospital stay duration was 3.0 days (interquartile range, 2.0–5.0), ICU admission rate was 3.3% (95% CI, 3.2–3.3%), and in-hospital CFR was 4.6% (95% CI, 4.5–4.7). In Mexico, the median duration of stay was 5.0 days (interquartile range, 3.0–7.0), ICU admission rate was 1.8% (95% CI, 1.6–2.0%), and in-hospital CFR was 6.9% (95% CI, 6.5–7.2). In Brazil, ICU admission and in-hospital CFR were higher in adults aged ≥50 years and increased in the presence of comorbidities, especially cardiovascular disease. In Mexico, comorbidities increased the risk of ICU admission by 1.9 (95% CI, 1.0–3.5) and in-hospital CFR by 13.9 (95% CI, 8.4–22.9) in children 0–4 years.
Conclusion
The SIH/SUS and SAEH databases can be used to estimate hospital admissions with influenza, and the disease severity. Age and comorbidities, especially cardiovascular disease, are cumulatively associated with more severe outcomes, with differences between countries. This association should be further analyzed in prospective surveillance studies designed to support influenza vaccination strategy decisions.
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Nguyen TT, Le NTH, Nguyen NM, Do VC, Trinh TH, Vo LT. Clinical features and management of children with dengue-associated obstructive shock syndrome: A case report. Medicine (Baltimore) 2022; 101:e31322. [PMID: 36316901 PMCID: PMC9622697 DOI: 10.1097/md.0000000000031322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
RATIONALE Dengue obstructive shock syndrome is a fatal complication commonly observed in the late critical phase of dengue infection and is associated with a high mortality rate. The main pathogenesis involves a dramatic increase in chest pressure, owing to severe plasma leakage and mechanical respiratory support, hampering the heart's ability to pump effectively and impeding adequate blood venous return to the heart chambers. To date, there is a paucity of clinical data about Dengue obstructive shock syndrome reported. PATIENT CONCERNS The 2 reported patients presented with prolonged and decompensated dengue shock with critical multi-organ failures and mechanical ventilation. The patients' hemodynamics were profoundly affected by high pressure in the thoracic and abdominal cavities resulting from Dengue-induced severe plasma leakage and mechanical ventilation. DIAGNOSES Clinical presentations, laboratory data, mini-fluid challenge test, and point-of-care (POCUS) were used to make diagnoses and guide management. INTERVENTIONS Clinical monitoring, judicious fluid (colloids and blood products) administration guided by repeated POCUS to properly assess the adequacy of the intravascular volume, homeostasis adjustments by plasma exchange, and continuous renal replacement therapies. OUTCOMES The patients had favorable outcomes. LESSONS Our study highlights the clinical manifestations and management of children with dengue obstructive shock syndrome and underscores the importance of monitoring hemodynamics by consecutive POCUS at the bedside in order to make a timely diagnosis and assess intravascular fluid volume inadequacy accurately as well as closely monitor the fluid management responses.
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Affiliation(s)
- Thanh Tat Nguyen
- Department of Infectious Diseases, Children’s Hospital No.2, Ho Chi Minh City, Vietnam
- Woolcock Institute of Medical Research, Ho Chi Minh City, Vietnam
| | - Nhung Thi-Hong Le
- Pediatric Department, Binh Duong General Hospital, Binh Duong, Vietnam
| | - Ngoc Minh Nguyen
- Department of Infectious Diseases, Children’s Hospital No.2, Ho Chi Minh City, Vietnam
| | - Viet Chau Do
- Department of Infectious Diseases, Children’s Hospital No.2, Ho Chi Minh City, Vietnam
| | - Tung Huu Trinh
- Department of Infectious Diseases, Children’s Hospital No.2, Ho Chi Minh City, Vietnam
| | - Luan Thanh Vo
- Department of Infectious Diseases, Children’s Hospital No.2, Ho Chi Minh City, Vietnam
- * Correspondence: Luan Thanh Vo, Infectious Disease Department, Children Hospital No.2, Ho Chi Minh City, Vietnam (e-mail: )
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Sekaran SD, Liew ZM, Yam HC, Raju CS. The association between diabetes and obesity with Dengue infections. Diabetol Metab Syndr 2022; 14:101. [PMID: 35864519 PMCID: PMC9301891 DOI: 10.1186/s13098-022-00870-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 06/28/2022] [Indexed: 12/03/2022] Open
Abstract
Dengue, an arboviral disease is a global threat to public health as the number of Dengue cases increases through the decades and this trend is predicted to continue. Non-communicable diseases such as diabetes and obesity are also on an upward trend. Moreover, past clinical studies have shown comorbidities worsen the clinical manifestation of especially Severe Dengue. However, discussion regarding the underlying mechanisms regarding the association between these comorbidities and dengue are lacking. The hallmark of Severe Dengue is plasma leakage which is due to several factors including presence of pro-inflammatory cytokines and dysregulation of endothelial barrier protein expression. The key factors of diabetes affecting endothelial functions are Th1 skewed responses and junctional-related proteins expression. Additionally, obesity alters the lipid metabolism and immune response causing increased viral replication and inflammation. The similarity between diabetes and obesity individuals is in having chronic inflammation resulting in endothelial dysfunction. This review outlines the roles of diabetes and obesity in severe dengue and gives some insights into the plausible mechanisms of comorbidities in Severe Dengue.
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Affiliation(s)
- S D Sekaran
- Faculty of Medicine and Health Sciences, UCSI University Springhill Campus, Port Dickson, 70100, Negri Sembilan, Malaysia.
| | - Z M Liew
- Faculty of Applied Science, UCSI University Kuala Lumpur, Kuala Lumpur, 56000, Malaysia
| | - H C Yam
- Faculty of Applied Science, UCSI University Kuala Lumpur, Kuala Lumpur, 56000, Malaysia
| | - C S Raju
- Department of Medical Microbiology, Faculty of Medicine, University Malaya, Kuala Lumpur, 50603, Malaysia
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Dias HG, dos Santos FB, Pauvolid-Corrêa A. An Overview of Neglected Orthobunyaviruses in Brazil. Viruses 2022; 14:v14050987. [PMID: 35632729 PMCID: PMC9146330 DOI: 10.3390/v14050987] [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: 03/18/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 02/04/2023] Open
Abstract
Dozens of orthobunyaviruses have been isolated in Brazil, and at least thirteen have been associated with human disease. The Oropouche virus has received most attention for having caused explosive epidemics with hundreds of thousands of cases in the north region between the 1960sand the 1980s, and since then has been sporadically detected elsewhere in the country. Despite their importance, little is known about their enzootic cycles of transmission, amplifying hosts and vectors, and biotic and abiotic factors involved in spillover events to humans. This overview aims to combine available data of neglected orthobunyaviruses of several serogroups, namely, Anopheles A, Anopheles B, Bunyamwera, California, Capim, Gamboa, Group C, Guama, Simbu and Turlock, in order to evaluate the current knowledge and identify research gaps in their natural transmission cycles in Brazil to ultimately point to the future direction in which orthobunyavirus research should be guided.
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Affiliation(s)
- Helver Gonçalves Dias
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil;
- Correspondence:
| | - Flávia Barreto dos Santos
- Laboratório de Imunologia Viral, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro 21040-900, Brazil;
| | - Alex Pauvolid-Corrêa
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, TX 77843-4458, USA;
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11
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Aedes aegypti Shows Increased Susceptibility to Zika Virus via Both In Vitro and In Vivo Models of Type II Diabetes. Viruses 2022; 14:v14040665. [PMID: 35458395 PMCID: PMC9024453 DOI: 10.3390/v14040665] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/11/2022] [Accepted: 03/18/2022] [Indexed: 11/16/2022] Open
Abstract
Chronic conditions like type II diabetes (T2DM) have long been known to exacerbate many infectious diseases. For many arboviruses, including Zika virus (ZIKV), severe outcomes, morbidity and mortality usually only occur in patients with such pre-existing conditions. However, the effects of T2DM and other pre-existing conditions on human blood (e.g., hypo/hyperinsulinemia, hyperglycemia and hyperlipidemia) that may impact infectivity of arboviruses for vectors is largely unexplored. We investigated whether the susceptibility of Aedes aegypti mosquitoes was affected when the mosquitoes fed on “diabetic” bloodmeals, such as bloodmeals composed of artificially glycosylated erythrocytes or those from viremic, diabetic mice (LEPRDB/DB). Increasing glycosylation of erythrocytes from hemoglobin A1c (HgbA1c) values of 5.5–5.9 to 6.2 increased the infection rate of a Galveston, Texas strain of Ae. aegypti to ZIKV strain PRVABC59 at a bloodmeal titer of 4.14 log10 FFU/mL from 0.0 to 40.9 and 42.9%, respectively. ZIKV was present in the blood of viremic LEPRDB/DB mice at similar levels as isogenic control C57BL/6J mice (3.3 log10 FFU/mL and 3.6 log10 FFU/mL, respectively. When mice sustained a higher ZIKV viremia of 4.6 log10 FFU/mL, LEPRDB/DB mice infected 36.3% of mosquitoes while control C57BL/6J mice with a viremia of 4.2 log10 FFU/mL infected only 4.1%. Additionally, when highly susceptible Ae. aegypti Rockefeller mosquitoes fed on homozygous LEPRDB/DB, heterozygous LEPRWT/DB, and control C57BL/6J mice with viremias of ≈ 4 log10 FFU/mL, 54%, 15%, and 33% were infected, respectively. In total, these data suggest that the prevalence of T2DM in a population may have a significant impact on ZIKV transmission and indicates the need for further investigation of the impacts of pre-existing metabolic conditions on arbovirus transmission.
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12
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Dengue and Chikungunya virus co-infection in major metropolitan cities of provinces of Punjab and Khyber Pakhtunkhwa: A multi-center study. PLoS Negl Trop Dis 2021; 15:e0009802. [PMID: 34555034 PMCID: PMC8491885 DOI: 10.1371/journal.pntd.0009802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 10/05/2021] [Accepted: 09/09/2021] [Indexed: 11/19/2022] Open
Abstract
Dengue has become endemic in Pakistan with annual recurrence. A sudden increase in the dengue cases was reported from Rawalpindi in 2016, while an outbreak occurred for the first time in Peshawar in 2017. Therefore, a multi-center study was carried out to determine the circulating dengue virus (DENV) serotypes and Chikungunya virus (CHIKV) co-infection in Lahore, Rawalpindi, and Peshawar cities in 2016–18. A hospital-based cross-sectional study was carried out in Lahore and Rawalpindi in 2016–18, while a community-based study was carried out in Peshawar in 2017. The study participants were tested for dengue NS1 antigen using an immunochromatographic device while anti-dengue IgM/IgG antibodies were detected by indirect ELISA. All NS1 positive samples were used for DENV serotyping using multiplex real-time PCR assay. Additionally, dengue samples were tested for CHIKV co-infection using IgM/IgG ELISA. A total of 6291 samples were collected among which 8.11% were NS1 positive while 2.5% were PCR positive. DENV-2 was the most common serotype (75.5%) detected, followed by DENV-1 in 16.1%, DENV-3 in 3.9% and DENV-4 in 0.7% while DENV-1 and DENV-4 concurrent infections were detected in 3.9% samples. DENV-1 was the predominant serotype (62.5%) detected from Lahore and Rawalpindi, while DENV-2 was the only serotype detected from Peshawar. Comorbidities resulted in a significant increase (p-value<0.001) in the duration of hospital stay of the patients. Type 2 diabetes mellitus substantially (p-value = 0.004) contributed to the severity of the disease. Among a total of 590 dengue positive samples, 11.8% were also positive for CHIKV co-infection. Co-circulation of multiple DENV serotypes and CHIKV infection in Pakistan is a worrisome situation demanding the urgent attention of the public health experts to strengthen vector surveillance. Mosquitoes are responsible for the transmission of many different types of infectious pathogens and parasites to humans. Some of these pathogens include viruses like dengue and chikungunya viruses which cause diseases in humans. Dengue virus has four different types (1, 2, 3, and 4) present in nature. In this study, we detected all four dengue virus types in hospitalized patients in Lahore and Rawalpindi. While only dengue virus type-2 was detected from Peshawar city. The secondary infections with different dengue virus types than the previous one might result in a more severe form of the disease. Therefore, the population of Peshawar is at risk of developing a severe form of dengue fever in the future in case of infection from another dengue virus type. The data of hospitalized patients showed that other diseases in addition to dengue fever result in an increased hospital stay. Comorbidities like diabetes also increase the risk of developing a more severe form of dengue fever. Combined infections of both dengue and chikungunya viruses were detected from Lahore, Rawalpindi, and Peshawar. The transmission of dengue and chikungunya viruses and the co-circulation of multiple dengue virus types not only impose public health burden but also result in economic losses.
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13
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Tan KW, Tan B, Thein TL, Leo YS, Lye DC, Dickens BL, Wong JGX, Cook AR. Dynamic dengue haemorrhagic fever calculators as clinical decision support tools in adult dengue. Trans R Soc Trop Med Hyg 2021; 114:7-15. [PMID: 31943116 DOI: 10.1093/trstmh/trz099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/21/2019] [Accepted: 08/15/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The objective of this study was to develop multiple prediction tools that calculate the risk of developing dengue haemorrhagic fever. METHODS Training data consisted of 1771 individuals from 2006-2008 admitted with dengue fever whereby 304 developed dengue haemorrhagic fever during hospitalisation. Least absolute shrinkage and selection operator regression was used to construct three types of calculators, static admission calculators and dynamic calculators that predict the risk of developing dengue haemorrhagic fever for a subsequent day (DAily Risk Tomorrow [DART]) or for any future point after a specific day since fever onset (DAily Risk Ever [DARE]). RESULTS From 119 admission covariates, 35 were in at least one of the calculators, which reported area under the curve (AUC) values of at least 0.72. Addition of person-time data for DART improved AUC to 0.76. DARE calculators displayed a large increase in AUC to 0.79 past day 7 with the inclusion of a strong predictor, maximum temperature on day 6 since onset, indicative of a saddleback fever. CONCLUSIONS All calculators performed well when validated with 2005 data. Addition of daily variables further improved the accuracy. These calculators can be used in tandem to assess the risk of dengue haemorrhagic fever upon admission and updated daily to obtain more precise risk estimates.
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Affiliation(s)
- Ken Wei Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore 117549
| | - Ben Tan
- Ministry of Education, 1 North Buona Vista Drive, Singapore 138675
| | - Tun L Thein
- National Centre for Infectious Diseases, 16 Jln Tan Tock Seng, Singapore 308442
| | - Yee-Sin Leo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore 117549.,National Centre for Infectious Diseases, 16 Jln Tan Tock Seng, Singapore 308442.,Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433.,Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597.,Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Singapore 636921
| | - David C Lye
- National Centre for Infectious Diseases, 16 Jln Tan Tock Seng, Singapore 308442.,Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433.,Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597.,Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Singapore 636921
| | - Borame L Dickens
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore 117549
| | | | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, Singapore 117549
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14
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Mwanyika GO, Mboera LEG, Rugarabamu S, Ngingo B, Sindato C, Lutwama JJ, Paweska JT, Misinzo G. Dengue Virus Infection and Associated Risk Factors in Africa: A Systematic Review and Meta-Analysis. Viruses 2021; 13:536. [PMID: 33804839 PMCID: PMC8063827 DOI: 10.3390/v13040536] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 01/09/2023] Open
Abstract
Dengue contributes a significant burden on global public health and economies. In Africa, the burden of dengue virus (DENV) infection is not well described. This review was undertaken to determine the prevalence of dengue and associated risk factors. A literature search was done on PubMed/MEDLINE, Scopus, Embase, and Google Scholar databases to identify articles published between 1960 and 2020. Meta-analysis was performed using a random-effect model at a 95% confidence interval, followed by subgroup meta-analysis to determine the overall prevalence. Between 1960 and 2020, 45 outbreaks were identified, of which 17 and 16 occurred in East and West Africa, respectively. Dengue virus serotype 1 (DENV-1) and DENV-2 were the dominant serotypes contributing to 60% of the epidemics. Of 2211 cases reported between 2009 and 2020; 1954 (88.4%) were reported during outbreaks. Overall, the prevalence of dengue was 29% (95% CI: 20-39%) and 3% (95% CI: 1-5%) during the outbreak and non-outbreak periods, respectively. Old age (6/21 studies), lack of mosquito control (6/21), urban residence (4/21), climate change (3/21), and recent history of travel (3/21) were the leading risk factors. This review reports a high burden of dengue and increased risk of severe disease in Africa. Our findings provide useful information for clinical practice and health policy decisions to implement effective interventions.
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Affiliation(s)
- Gaspary O. Mwanyika
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania; (G.O.M.); (L.E.G.M.); (S.R.); (B.N.); (C.S.)
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, P.O. Box 3015 Morogoro, Tanzania
- Department of Health Science and Technology, Mbeya University of Science and Technology, P.O. Box 131 Mbeya, Tanzania
| | - Leonard E. G. Mboera
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania; (G.O.M.); (L.E.G.M.); (S.R.); (B.N.); (C.S.)
| | - Sima Rugarabamu
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania; (G.O.M.); (L.E.G.M.); (S.R.); (B.N.); (C.S.)
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, P.O. Box 3015 Morogoro, Tanzania
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65595 Dar es Salaam, Tanzania
| | - Baraka Ngingo
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania; (G.O.M.); (L.E.G.M.); (S.R.); (B.N.); (C.S.)
- Biology Department, St. John’s University of Tanzania, P.O. Box 47 Dodoma, Tanzania
| | - Calvin Sindato
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania; (G.O.M.); (L.E.G.M.); (S.R.); (B.N.); (C.S.)
- Tabora Research Centre, National Institute for Medical Research, P.O. Box 482 Tabora, Tanzania
| | - Julius J. Lutwama
- Department of Arbovirology, Emerging and Re-emerging Infectious Diseases, Uganda Virus Research Institute, P.O. Box 49 Entebbe, Uganda;
| | - Janusz T. Paweska
- National Health Laboratory Service, National Institute for Communicable Diseases, Sandringham, 2192 Johannesburg, South Africa;
| | - Gerald Misinzo
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297 Morogoro, Tanzania; (G.O.M.); (L.E.G.M.); (S.R.); (B.N.); (C.S.)
- Department of Veterinary Microbiology, Parasitology and Biotechnology, Sokoine University of Agriculture, P.O. Box 3015 Morogoro, Tanzania
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15
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Clinical and biochemical parameters of COVID-19 patients with prior or active dengue fever. Acta Trop 2021; 214:105782. [PMID: 33259817 PMCID: PMC7698682 DOI: 10.1016/j.actatropica.2020.105782] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 01/10/2023]
Abstract
Originated in Wuhan, China, the coronavirus 19 disease (COVID-19) has quickly spread worldwide, reaching countries that already faced other endemics and epidemics. In Brazil, such a concerning situation includes arboviruses, among which the dengue virus stands out. Here, we determined the rate of SARS-CoV-2/dengue virus co-infection in a total of 178 patients with COVID-19 symtoms admitted into a large public hospital of the Federal District of Brazil. Furthermore, we evaluated whether prior or active dengue virus infection influenced hematological, biochemical, and clinical parameters of such patients. One hundred and twelve (63%) individuals tested positive for COVID-19, of which 43 (38.4%) were co-infected with dengue virus, and 50 (44.6%) had antibodies indicative of previous dengue infection. Co-infected patients showed lower numbers of circulating lymphocytes and monocytes, higher glucose rates, and a worse pulmonary condition. Of note, prior infections with dengue virus did not influence clinical parameters, but active dengue fever resulted in higher hospitalization rate. In conclusion, amid the current complex epidemiological scenario in Brazil, our data support the notion that SARS-CoV-2 and dengue co-infection affects an important percentage of COVID-19 patients and leads to worse clinical parameters, requiring greater attention from health authorities.
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16
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Kanakan A, Mishra N, Srinivasa Vasudevan J, Sahni S, Khan A, Sharma S, Pandey R. Threading the Pieces Together: Integrative Perspective on SARS-CoV-2. Pathogens 2020; 9:E912. [PMID: 33158051 PMCID: PMC7694192 DOI: 10.3390/pathogens9110912] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has challenged the research community globally to innovate, interact, and integrate findings across hierarchies. Research on SARS-CoV-2 has produced an abundance of data spanning multiple parallels, including clinical data, SARS-CoV-2 genome architecture, host response captured through transcriptome and genetic variants, microbial co-infections (metagenome), and comorbidities. Disease phenotypes in the case of COVID-19 present an intriguing complexity that includes a broad range of symptomatic to asymptomatic individuals, further compounded by a vast heterogeneity within the spectrum of clinical symptoms displayed by the symptomatic individuals. The clinical outcome is further modulated by the presence of comorbid conditions at the point of infection. The COVID-19 pandemic has produced an expansive wealth of literature touching many aspects of SARS-CoV-2 ranging from causal to outcome, predisposition to protective (possible), co-infection to comorbidity, and differential mortality globally. As challenges provide opportunities, the current pandemic's challenge has underscored the need and opportunity to work for an integrative approach that may be able to thread together the multiple variables. Through this review, we have made an effort towards bringing together information spanning across different domains to facilitate researchers globally in pursuit of their response to SARS-CoV-2.
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Affiliation(s)
| | | | | | | | | | | | - Rajesh Pandey
- INtegrative GENomics of HOst-PathogEn (INGEN-HOPE) Laboratory, CSIR-Institute of Genomics and Integrative Biology (CSIR-IGIB), Delhi 110007, India; (A.K.); (N.M.); (J.S.V.); (S.S.); (A.K.); (S.S.)
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Aguilar-Briseño JA, Moser J, Rodenhuis-Zybert IA. Understanding immunopathology of severe dengue: lessons learnt from sepsis. Curr Opin Virol 2020; 43:41-49. [PMID: 32896675 DOI: 10.1016/j.coviro.2020.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/09/2020] [Indexed: 12/13/2022]
Abstract
Endothelial dysfunction leading to vascular permeability and plasma leakage are characteristic features of severe dengue and sepsis. However, the mechanisms underlying these immune-pathologies remain unclear. The risk of severe dengue and sepsis development depend on patient-related and pathogen-related factors. Additionally, comorbidities increase the risk of severe disease and their incidence hampers correct diagnosis and treatments. To date, there is no efficient therapy to combat severe dengue and sepsis. Here, we discuss the differences and similarities between the pathogenesis of severe dengue and that of bacterial sepsis. We identify gaps in knowledge that need to be better understood in order to move towards the rational development and/or usage of therapeutic strategies to ameliorate severe dengue disease.
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Affiliation(s)
- José A Aguilar-Briseño
- Department of Medical Microbiology and Infection Prevention, University of Groningen and University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Jill Moser
- Departments of Critical Care, Pathology & Medical Biology, Medical Biology Section, University of Groningen and University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Izabela A Rodenhuis-Zybert
- Department of Medical Microbiology and Infection Prevention, University of Groningen and University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
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Chia PY, Thein TL, Ong SWX, Lye DC, Leo YS. Severe dengue and liver involvement: an overview and review of the literature. Expert Rev Anti Infect Ther 2020; 18:181-189. [PMID: 31971031 DOI: 10.1080/14787210.2020.1720652] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: Two billion population are at risk of dengue fever and by 2080, over six billion population will be at risk. Hepatitis is common in dengue and the liver is invariably involved in severe cases. We conducted a literature review using the PubMed database on articles covering a broad range of issues related to dengue and hepatitis.Areas covered: This article overviews available literature on changes in the definition of severe dengue, pathogenesis of liver involvement in dengue, clinical manifestations, and predictors of mortality in severe dengue with liver involvement, impact of viral hepatitis co-infections and hepatotoxic drugs, and hemophagocytic lymphohistiocytosis.Expert commentary: Hepatitis is commonly seen in dengue however the degree of elevation of transaminases did not correlate well with severity of illness in observational studies, except in the elderly. The underlying pathogenesis of liver injury is still being elucidated and further studies are required to fully understand the cellular pathways. Acute or chronic viral hepatitis does not appear to affect dengue outcomes. Commonly used medications such as paracetamol and statins may influence dengue outcomes.
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Affiliation(s)
- Po Ying Chia
- National Centre for Infectious Diseases, Singapore, Singapore.,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore
| | - Tun-Linn Thein
- National Centre for Infectious Diseases, Singapore, Singapore
| | - Sean Wei Xiang Ong
- National Centre for Infectious Diseases, Singapore, Singapore.,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
| | - David Chien Lye
- National Centre for Infectious Diseases, Singapore, Singapore.,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yee Sin Leo
- National Centre for Infectious Diseases, Singapore, Singapore.,Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Gasem MH, Kosasih H, Tjitra E, Alisjahbana B, Karyana M, Lokida D, Neal A, Liang CJ, Aman AT, Arif M, Sudarmono P, Suharto, Merati TP, Lisdawati V, Siswanto, Siddiqui S, Lane HC. An observational prospective cohort study of the epidemiology of hospitalized patients with acute febrile illness in Indonesia. PLoS Negl Trop Dis 2020; 14:e0007927. [PMID: 31923174 PMCID: PMC6977771 DOI: 10.1371/journal.pntd.0007927] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/23/2020] [Accepted: 11/14/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The epidemiology of acute febrile illness, a common cause of hospitalization in Indonesia, has not been systematically studied. METHODOLOGY/PRINCIPAL FINDINGS This prospective observational study enrolled febrile patients (temperature ≥38°C) aged ≥1 year from July 2013 until June 2016 at eight government referral teaching hospitals in seven provincial capitals in Indonesia. Patients were managed according to the hospital standard-of-care (SOC), and blood samples were drawn for molecular and serological assays. Clinical data, laboratory results, and specimens for additional tests were collected at enrollment, days 14-28, and at three months. Regular follow-up visits were then scheduled for every three months either until symptoms resolved or until one year. In total, this study included 1,486 adult and pediatric patients presenting with multi-organ (768, 51.7%), gastrointestinal (497, 33.0%), respiratory (114, 7.7%), constitutional (62, 4.2%), skin and soft-tissue (24, 1.6%), central nervous system (17, 1.1%), or genitourinary (4, 0.3%) manifestations. Microbiological diagnoses were found in 1,003/1,486 (67.5%) participants, of which 351/1,003 (35.0%) were not diagnosed during hospitalization using SOC diagnostic tests. Missed diagnoses included all cases caused by Rickettsia spp., chikungunya, influenza, and Seoul virus. The most common etiologic agents identified were dengue virus (467, 46.6%), Salmonella spp. (103, 10.3%), and Rickettsia spp. (103, 10.3%). The overall mortality was 89 (5.9%). CONCLUSIONS/SIGNIFICANCE Febrile illness in Indonesia has various microbiologic etiologies and substantial overall mortality. Diagnostic limitations and lack of epidemiologic data resulted in potentially treatable, and at times fatal, diseases being missed.
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Affiliation(s)
| | - Herman Kosasih
- Indonesia Research Partnership on Infectious Disease (INA-RESPOND), Jakarta, Indonesia
| | - Emiliana Tjitra
- National Institute of Health Research and Development, Ministry of Health, Republic of Indonesia, Jakarta, Indonesia
| | | | - Muhammad Karyana
- National Institute of Health Research and Development, Ministry of Health, Republic of Indonesia, Jakarta, Indonesia
| | - Dewi Lokida
- Department of Clinical Pathology, Tangerang District Hospital, Tangerang, Indonesia
| | - Aaron Neal
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - C. Jason Liang
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Abu Tholib Aman
- Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mansyur Arif
- Faculty of Medicine, Universitas Hasanudin, Makassar, Indonesia
| | | | - Suharto
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Vivi Lisdawati
- Sulianti Saroso, Infectious Disease Hospital, Jakarta, Indonesia
| | - Siswanto
- National Institute of Health Research and Development, Ministry of Health, Republic of Indonesia, Jakarta, Indonesia
| | - Sophia Siddiqui
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - H. Clifford Lane
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States of America
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Tiguman GMB, Silva MT, Souza KM, Galvao TF. Prevalence of self-reported dengue infections in Manaus Metropolitan Region: a cross-sectional study. Rev Soc Bras Med Trop 2019; 52:e20190232. [PMID: 31508784 DOI: 10.1590/0037-8682-0232-2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/18/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Dengue is an endemic and epidemic disease in Brazil, with a high burden of disease. Amazonas State has a high risk of transmission. This study aimed to assess the self-reported prevalence of dengue in adults living in Manaus Metropolitan Region. METHODS A cross-sectional study was conducted with adults living in Manaus Metropolitan Region in 2015. We performed a three-phase probabilistic sampling to collect participants' clinical and sociodemographic data. Self-reported dengue infection in the previous year was the primary outcome. Descriptive statistics and Poisson regression analysis with robust variance were used to calculate the prevalence ratio (PR) of dengue infections with 95% confidence intervals (95% CIs). Multilevel analysis including city and neighborhood variables was calculated. All analyses considered the complex sampling. RESULTS Among the 4,001 participants, dengue in the previous year was self-reported by 7.0% (95% CI 6.3%-7.8%). Dengue was more frequent in women(PR 1.51; 95% CI 1.06-2.13), elderly participants (≥60 years old, PR 2.54; 95% CI 1.19-5.45), White and Asian participants (PR, 1.57; 95% CI, 1.11-2.23), and individuals who had not received endemic agent visits (PR, 2.28; 95% CI, 1.31-3.99). After multilevel analysis, sex was no longer a significant variable, with the remaining associations still significant. CONCLUSIONS Seven out of 100 inhabitants of Manaus Metropolitan Region reported dengue in the previous year. Dengue was predominantly observed in women, elderly individuals, White and Asian individuals, and individuals who did not receive endemic agent visits. The setting plays an important role in dengue infections.
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Affiliation(s)
| | - Marcus Tolentino Silva
- Universidade de Sorocaba, Programa de Pós-graduação em Ciências Farmacêuticas, Sorocaba, SP, Brasil
| | | | - Tais Freire Galvao
- Universidade de Campinas, Faculdade de Ciências Farmacêuticas, Campinas, SP, Brasil
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Zhang SF, Yang ZD, Huang ML, Wang ZB, Hu YY, Miao D, Dai K, Du J, Cui N, Yuan C, Li H, Li XK, Zhang XA, Zhang PH, Mi XM, Lu QB, Liu W. Preexisting chronic conditions for fatal outcome among SFTS patients: An observational Cohort Study. PLoS Negl Trop Dis 2019; 13:e0007434. [PMID: 31136581 PMCID: PMC6555536 DOI: 10.1371/journal.pntd.0007434] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 06/07/2019] [Accepted: 05/02/2019] [Indexed: 02/07/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that is caused by a novel bunyavirus SFTSV. Currently our knowledge of the host-related factors that influence the pathogenesis of disease is inadequate to allow prediction of fatal outcome. Here we conducted a prospective study of the largest database on the SFTS patients, to identify the presence of comorbidities in SFTS, and estimate their effect on the fatal outcome. Among 2096 patients eligible for inclusion, we identified nine kinds of comorbidities, from which hyperlipidemia (12.2%; 95% CI: 10.8%–13.6%), hypertension (11.0%; 95% CI: 9.6%–12.3%), chronic viral hepatitis (CVH) (9.3%; 95% CI: 8.1%–10.5%), and diabetes mellitus (DM) (6.8%; 95% CI: 5.7%–7.9%) were prevalent. Higher risk of death was found in patients with DM (adjusted OR = 2.304; 95% CI: 1.520–3.492; P<0.001), CVH (adjusted OR = 1.551; 95% CI: 1.053–2.285; P = 0.026) and chronic obstructive pulmonary diseases (COPD) (adjusted OR = 2.170; 95% CI: 1.215–3.872; P = 0.009) after adjusting for age, sex, delay from disease onset to admission and treatment regimens. When analyzing the comorbidities separately, we found that the high serum glucose could augment diseases severity. Compared to the group with max glucose < 7.0 mmol/L, patients with glucose between 7.0–11.1 mmol/L and glucose ≥11.1 mmol/L conferred higher death risk, with the adjusted OR to be 1.467 (95% CI: 1.081–1.989; P = 0.014) and 3.443 (95% CI: 2.427–4.884; P<0.001). Insulin therapy could effectively reduce the risk of severe outcome in DM patients with the adjusted OR 0.146 (95% CI: 0.058–0.365; P<0.001). For CVH patients, severe damage of liver and prolongation of blood coagulation time, as well as high prevalence of bleeding phenotype were observed. These data supported the provocative hypothesis that treating SFTS related complications can attain potentially beneficial effects on SFTS. SFTS now brings about a substantial global public health concern. Preexisting chronic conditions were thought to increase risk of severe SFTSV infections, however with sparse data mining efforts. In this study, we quantified the frequency of chronic comorbidities in SFTS, estimated their contribution to disease severity, and separately evaluated the effect from diabetes mellitus and chronic viral hepatitis on resulting in fatal outcome.
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Affiliation(s)
- Shao-Fei Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, PR China
| | - Zhen-Dong Yang
- The 990 Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Xinyang, PR China
| | - Mao-Lin Huang
- The 990 Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Xinyang, PR China
| | - Zhi-Bo Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, PR China
| | - Yuan-Yuan Hu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, PR China
| | - Dong Miao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, PR China
| | - Ke Dai
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, PR China
| | - Juan Du
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, PR China
| | - Ning Cui
- The 990 Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Xinyang, PR China
| | - Chun Yuan
- The 990 Hospital of Chinese People's Liberation Army Joint Logistic Support Force, Xinyang, PR China
| | - Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, PR China
| | - Xiao-Kun Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, PR China
| | - Xiao-Ai Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, PR China
| | - Pan-He Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, PR China
| | - Xian-Miao Mi
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, PR China
- * E-mail: (XMM); (QBL); (WL)
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, PR China
- * E-mail: (XMM); (QBL); (WL)
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, PR China
- Beijing Key Laboratory of Vector Borne and Natural Focus Infectious Diseases, Beijing, PR China
- * E-mail: (XMM); (QBL); (WL)
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Burdmann EA. Flaviviruses and Kidney Diseases. Adv Chronic Kidney Dis 2019; 26:198-206. [PMID: 31202392 DOI: 10.1053/j.ackd.2019.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 12/17/2022]
Abstract
The genus Flavivirus comprises approximately 73 viruses, which share several common aspects, such as dimension, structure, nucleic acid properties, and shape in electronic microscopy. Global incidence of flavivirus infection increased dramatically over the last decades, causing large outbreaks in several areas of the world. These viruses are expanding from endemic tropical and subtropical areas to previously nonendemic areas, affecting and causing diseases in millions of individuals worldwide and posing a formidable challenge to public health in several countries. The majority of clinically significant flavivirus-associated infections are mosquito borne (arboviruses-acronym for ARthropod-BOrne VIRUSES), such as dengue, yellow fever, Japanese encephalitis, Zika, and West Nile fever. Most diseases caused by flaviviruses are asymptomatic or manifest as self-limited, mild, undifferentiated febrile diseases. In a limited number of cases, these diseases may evolve to severe inflammatory, multisystem diseases, causing high morbidity and mortality. Some flaviviruses have been consistently identified in kidney tissue and urine and have been clinically associated with kidney diseases. In this review, we will provide an overview of the epidemiology, risk factors, kidney pathology, etiopathogenesis, and outcomes of acute and chronic kidney syndromes associated with dengue, yellow fever, Zika, and West Nile virus disease.
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