Portal de Periódicos da CAPES

Impaired quality of life after chikungunya virus infection: a 2-year follow-up study of its chronic inflammatory rheumatism in La Virginia, Risaralda, Colombia

2018; Elsevier BV; Volume: 73; Linguagem: Inglês

10.1016/j.ijid.2018.04.3663

1878-3511

Alfonso J. Rodríguez‐Morales, Sergio Andrés Ochoa-Orozco, Sabina Ocampo-Serna, Oscar Mauricio Meneses-Quintero, D.M. Sánchez-Castaño, Karol Liceth Hoyos-Guapacha, G. Botero-Castaño, J.C. Gutiérrez-Segura, Juan Daniel Castrillón-Spitia, José J. Londoño, Héctor D. Bedoya-Rendón, Javier de Jesús Cárdenas-Pérez, Jaime A. Cardona‐Ospina, C. González-Colonia, Guillermo J. Lagos-Grisales,

Autoimmune and Inflammatory Disorders Research

Background: Impact of post-chikungunya (CHIK) chronic inflammatory rheumatism (pCHIK-CIR) on Quality of Life (QoL) has been reported in some studies from La Reunion, France, India and Colombia. In this country our group published its consequence after 1-year of follow-up (Rheumatol Int. 2017). Methods & Materials: In a cohort study among 62 cases serologically diagnosed in La Virginia, Risaralda, Colombia, followed-up by 2-years, demographic and clinical characteristics were collected at baseline. QoL status by 36-item short-form health survey (SF-36) at 1-year and 2-years were assessed and compared. pCHIK-CIR cases were identified according to validated criteria (WHO/PAHO, 2015). Those with other arbovirosis during follow-up were excluded. Results: Of the total CHIK-infected subjects in this cohort, 43 (69.4%) reported persistent rheumatological symptoms (pCHIK-CIR). All dimensions of SF36 as well as physical and mental component summaries were impaired in pCHIK-CIR+ compared to pCHIK-CIR- subjects. Differences in median scores between both groups, pCHIK-CIR- with 83.2% and pCHIK-CIR+ with 51.4%, were statistically significant (p < 0.0001). In addition, in six dimensions, differences were also significant (p < 0.05) (physical functioning [89.5%/62.1%], role physical [89.5%/39.0%], bodily pain [88.2%/44.4%], general health [77.7%/51.4%], vitality [79.5%/506%] and health transition [68.4%/40.7%]). When compared evolution from 1-year to 2-year, the more prominent reduction was found in health transition from 50.9% to 40.7%, as well bodily pain from 51.6% to 44.%. Global median scores reduced from 54.2% to 51.4%. Conclusion: Despite possible cohort attrition bias, the comparability of pCHIK-CIR+/- subjects allows the confirmation of a long-term impact of CHIK infection with less chance of returning to a previous health status. We observed sharp reductions in QoL not only during active pCHIK-CIR+ associated illness but also for several months and now more than 2 years after infection compared to healthy normal subjects that reached clinical recovery. This has implications for developing intervention programmes in countries with high risk of CHIK outbreaks but also to consider the long-term impact of CHIK infection in a significant proportion of infected patients, even more considering that in countries such as Colombia, after the 2014-2015 epidemics (with estimations of 3 million cases), transmission still occurs with > 1,000 new cases in 2017.