Prediction of unfavorable outcomes in West Nile virus neuroinvasive infection - Result of a multinational ID-IRI study.

Adult Aged Aged, 80 and over Central Nervous System Diseases / diagnostic imaging Female Glasgow Coma Scale Hospitalization Humans Internationality Male Middle Aged Mortality Population Surveillance Predictive Value of Tests Retrospective Studies Tomography, X-Ray Computed West Nile Fever / epidemiology West Nile virus / pathogenicity

Death Encephalitis Meningitis Neuroinvasive WNV West Nile virus

Journal

Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology

ISSN: 1873-5967

Titre abrégé: J Clin Virol

Pays: Netherlands

ID NLM: 9815671

Informations de publication

Date de publication:
01 2020

Historique:

received: 30 08 2019

revised: 31 10 2019

accepted: 07 11 2019

pubmed: 30 11 2019

medline: 7 2 2021

entrez: 29 11 2019

Statut: ppublish

Résumé

WNV causes 1.4% of all central nervous system infections and is the most common cause of epidemic neuro-invasive disease in humans. Our main objective was to investigate retrospectively West Nile virus neuroinvasive disease (WNND) cases hospitalized during 2010-2017 and identified factors that can influence prognosis. We documented the demographic, epidemiologic, clinical and laboratory data of WNND and identified factors that can influence prognosis. The data were recruited through Infectious Diseases International Research Initiative (ID-IRI), which serves as a network for clinical researches. We investigated 165 patients with WNND in 10 countries from three continents. 27 patients died and the mortality rate was 16.4%. In an univariate analysis age, congestive heart failure, neoplasm and ischemic heart disease (p < 0.001), neuropsychiatric disorders (p = 0.011), chronic hepatitis (p = 0.024) and hypertension (p = 0.043) were risk factors for death. Fatal evolution was also correlated with ICU addmission, disorientation, speech disorders, change in consciousnes, coma, a low Glasgow coma score, obtundation, confusion (p < 0.001), history of syncope (p = 0.002) and history of unconsciousness (p = 0.037). In a binomial logistic regresssion analysis only age and coma remained independent prediction factors for death. We created an equation that was calculated according to age, co-morbidities and clinical manifestations that may be used to establish the prognosis of WNND patients. WNND remain an important factor for morbidity and mortality worldwide, evolution to death or survival with sequelae are not rare. Our study creates an equation that may be used in the future to establish the prognosis of WNND patients.

Sections du résumé

BACKGROUND

WNV causes 1.4% of all central nervous system infections and is the most common cause of epidemic neuro-invasive disease in humans.

OBJECTIVES

Our main objective was to investigate retrospectively West Nile virus neuroinvasive disease (WNND) cases hospitalized during 2010-2017 and identified factors that can influence prognosis.

STUDY DESIGN

We documented the demographic, epidemiologic, clinical and laboratory data of WNND and identified factors that can influence prognosis. The data were recruited through Infectious Diseases International Research Initiative (ID-IRI), which serves as a network for clinical researches.

RESULTS

We investigated 165 patients with WNND in 10 countries from three continents. 27 patients died and the mortality rate was 16.4%. In an univariate analysis age, congestive heart failure, neoplasm and ischemic heart disease (p < 0.001), neuropsychiatric disorders (p = 0.011), chronic hepatitis (p = 0.024) and hypertension (p = 0.043) were risk factors for death. Fatal evolution was also correlated with ICU addmission, disorientation, speech disorders, change in consciousnes, coma, a low Glasgow coma score, obtundation, confusion (p < 0.001), history of syncope (p = 0.002) and history of unconsciousness (p = 0.037). In a binomial logistic regresssion analysis only age and coma remained independent prediction factors for death. We created an equation that was calculated according to age, co-morbidities and clinical manifestations that may be used to establish the prognosis of WNND patients.

CONCLUSIONS

WNND remain an important factor for morbidity and mortality worldwide, evolution to death or survival with sequelae are not rare. Our study creates an equation that may be used in the future to establish the prognosis of WNND patients.

Identifiants

DOI: 10.1016/j.jcv.2019.104213 PMID: 31778945

pubmed: 31778945

pii: S1386-6532(19)30243-4

doi: 10.1016/j.jcv.2019.104213

pii:

doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

104213