Article Text
Abstract
Background Chikungunya Fever (CF) is an arbovirosis with a high attack rate, affecting large proportion of the population in its outbreaks (85%>90% of infected are symptomatic). In general, it is recommended to carry out laboratory tests when patients reach subacute phase or show signs of severity at the beginning of the disease. There are few studies showing which laboratory results are relevant and their clinical applicability.
Objectives To recognize the most frequent findings of laboratory tests in a cohort of patients with CF and chronic joint symptoms and to correlate laboratory results with clinical data.
Methods Patients with diagnosis of CF (clinical and epidemiological criteria) were followed in a cohort study. Clinical data and laboratory tests were collected in a regular schedule in the first months of the disease.
Results A total of 54 patients were enrolled during 10 months, persistent changes in some patients were recorded (table).
In the subacute phase, the ESR (erythrocyte sedimentation rate) correlated with number of swollen joints (r=0.45, p=0.03), VAS (visual analogue scale) of pain (r=0.72, p=0.0002), VAS patient's general health (r=0.50 p=0.02), VAS by physician (r=0.45, p=0.03) and with HAQ (r=0.51, p=0.01). In subacute phase the VAS of morning stiffness correlated with CRP (r=0.46, p=0.02). In chronic phase, CRP correlated with VAS of pain (r=0.47, p=0.02) and there was a reversal in the correlations between ESR and VAS of general health of the patient (r=-0.54, p=0.03), VAS of physician (r=-0.52, p=0.02), swollen joints (r=-0.46 p=0.03) and HAQ (r=-0.56, p=0.01). ESR and SF-12 (mental component) were correlated (r=0.61, p=0.01).
Conclusions Levels of ESR correlated with measures of pain and worsening of functional capacity in subacute phase. In chronic phase, there was reversal of this correlation, indicating that ESR does not reflect clinical worsening of patients at this stage. Further clinical studies are needed to better analize other alterations.
References
Weaver SC, Lecuit M. Chikungunya virus and the global spread of a mosquito-borne disease. N Engl J Med 2015 Mar 26;372(13):1231–9.
Brito CA, Sohsten AK, Leitão CC et al. Pharmacologic management of pain in patients with Chikungunya: a guideline. Rev Soc Bras Med Trop. 2016; 49(6):668–679.
References
Disclosure of Interest None declared