Article Text

PDF
AB0903 Laboratory findings in patients with chikungunya fever and chronic joint symptoms – a longitudinal assessment
  1. A Ranzolin1 2,
  2. RM Correia2,
  3. HD de Lima2,
  4. MRDA Freitas2,
  5. AFR de Oliveira2,
  6. ALBP Duarte1,
  7. CDL Marques1,
  8. PRS de Melo2,
  9. LF da Rocha Jr1 2
  1. 1Hospital Das Clínicas of Pernambuco
  2. 2Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil

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).

Table 1.

Persistent laboratory findings in patients with Chikungunya Fever in subacute/chronic phases

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

  1. 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.

  2. 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

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.