Chikungunya Death Risk Factors in Brazil, in 2017: A case-control study

• Published in: PloS one Vol. 17; no. 4; p. e0260939
• Main Authors: de Morais Alves Barbosa Oliveira, Rhaquel, Kalline de Almeida Barreto, Francisca, Praça Pinto, Geovana, Timbó Queiroz, Isabella, Montenegro de Carvalho Araújo, Fernanda, Wanderley Lopes, Kilma, Lúcia Sousa do Vale, Regina, Rocha Queiroz Lemos, Daniele, Washington Cavalcante, John, Machado Siqueira, André, Carla Vinhal Frutuoso, Lívia, Carmen Duarte, Elisabeth, Silva Lima Neto, Antônio, Ricardo Ribas Freitas, André, Pamplona de Góes Cavalcanti, Luciano
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 07-04-2022; Public Library of Science (PLoS)
• Subjects: Abdominal Pain; Albumins; Arthritis; Biology and life sciences; Brazil - epidemiology; Cardiovascular diseases; Care and treatment; Case studies; Case-Control Studies; Chikungunya fever; Chikungunya Fever - complications; Chikungunya Fever - diagnosis; Chikungunya Fever - epidemiology; Chikungunya virus; Coronary artery disease; Death; Dyspnea; Emotional behavior; Epidemics; Fatalities; Fever; Heart diseases; Humans; Kidney diseases; Kidneys; Laboratories; Leukocytosis; Leukopenia; Lymphocytes; Lymphopenia; Medical prognosis; Medicine and Health Sciences; Mortality; Multivariate analysis; Neutropenia; Pain; People and places; Renal Insufficiency, Chronic; Respiration; Risk analysis; Risk Factors; Signs and symptoms; Thrombocytopenia; Vector-borne diseases; Brazil
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0260939

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.
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.
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.
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.