A clinical scoring system to predict long-term arthralgia in Chikungunya disease: A cohort study.
<h4>Background</h4>Chikungunya virus (CHIKV) has caused worldwide epidemics that impose a major burden on health systems. Approximately half of infected individuals develop chronic debilitating arthralgia, affecting their quality of life. Here, we identified the relevant clinical and dem...
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doaj-377d9bca763748ebbb19d48e6fd7a70a2021-03-03T08:25:08ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352020-07-01147e000846710.1371/journal.pntd.0008467A clinical scoring system to predict long-term arthralgia in Chikungunya disease: A cohort study.Laise de MoraesThiago Cerqueira-SilvaVictor NobregaKevan AkramiLuciane Amorim SantosCibele OrgePaula CasaisLais CambuiRita de Cássia Pontello RampazzoKaren Soares TrintaCamila Amato MontalbanoMaria Jania TeixeiraLuciano Pamplona CavalcanteBruno B AndradeRivaldo Venâncio da CunhaMarco Aurélio KriegerManoel Barral-NettoAldina BarralRicardo KhouriViviane Sampaio Boaventura<h4>Background</h4>Chikungunya virus (CHIKV) has caused worldwide epidemics that impose a major burden on health systems. Approximately half of infected individuals develop chronic debilitating arthralgia, affecting their quality of life. Here, we identified the relevant clinical and demographic variables in the acute phase of CHIKV infection prospectively linked to chronic arthralgia to elaborate a prognostic scoring system.<h4>Methods</h4>Acute CHIKV infection cases (n = 134) confirmed by serology or molecular test were examined <10 days of disease onset and followed for one year to evaluate for disease progression. Potential risk factors for chronic arthralgia were evaluated by multivariate analysis to develop a prognostic scoring system, which was subsequently tested in an independent validation cohort consisting of 42 individuals.<h4>Results</h4>A total of 107 out of 134 (80%) acute CHIKV-confirmed cases from the derivation cohort were re-examined one year after enrollment. Chronic arthralgia post-CHIKV infection was diagnosed in 64 (60%). Five of the 12 parameters evaluated in the acute phase were statistically associated with persistent arthralgia and were further tested by Bayesian analysis. These variables were weighted to yield a prognosis score denominated SHERA (Sex, Hypertension, Edema, Retroocular pain, Age), which exhibited 81.3% accuracy in predicting long-term arthralgia post-CHIKV infection in the derivation cohort, and 76.5% accuracy in the validation cohort.<h4>Conclusions</h4>The simplified and externally validated prognostic scoring system, SHERA, is a useful method to screen acutely CHIKV-infected patients at elevated risk of chronic arthralgia who will benefit from specific interventions. This tool could guide public health policies, particularly in resource-constrained settings.https://doi.org/10.1371/journal.pntd.0008467 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Laise de Moraes Thiago Cerqueira-Silva Victor Nobrega Kevan Akrami Luciane Amorim Santos Cibele Orge Paula Casais Lais Cambui Rita de Cássia Pontello Rampazzo Karen Soares Trinta Camila Amato Montalbano Maria Jania Teixeira Luciano Pamplona Cavalcante Bruno B Andrade Rivaldo Venâncio da Cunha Marco Aurélio Krieger Manoel Barral-Netto Aldina Barral Ricardo Khouri Viviane Sampaio Boaventura |
spellingShingle |
Laise de Moraes Thiago Cerqueira-Silva Victor Nobrega Kevan Akrami Luciane Amorim Santos Cibele Orge Paula Casais Lais Cambui Rita de Cássia Pontello Rampazzo Karen Soares Trinta Camila Amato Montalbano Maria Jania Teixeira Luciano Pamplona Cavalcante Bruno B Andrade Rivaldo Venâncio da Cunha Marco Aurélio Krieger Manoel Barral-Netto Aldina Barral Ricardo Khouri Viviane Sampaio Boaventura A clinical scoring system to predict long-term arthralgia in Chikungunya disease: A cohort study. PLoS Neglected Tropical Diseases |
author_facet |
Laise de Moraes Thiago Cerqueira-Silva Victor Nobrega Kevan Akrami Luciane Amorim Santos Cibele Orge Paula Casais Lais Cambui Rita de Cássia Pontello Rampazzo Karen Soares Trinta Camila Amato Montalbano Maria Jania Teixeira Luciano Pamplona Cavalcante Bruno B Andrade Rivaldo Venâncio da Cunha Marco Aurélio Krieger Manoel Barral-Netto Aldina Barral Ricardo Khouri Viviane Sampaio Boaventura |
author_sort |
Laise de Moraes |
title |
A clinical scoring system to predict long-term arthralgia in Chikungunya disease: A cohort study. |
title_short |
A clinical scoring system to predict long-term arthralgia in Chikungunya disease: A cohort study. |
title_full |
A clinical scoring system to predict long-term arthralgia in Chikungunya disease: A cohort study. |
title_fullStr |
A clinical scoring system to predict long-term arthralgia in Chikungunya disease: A cohort study. |
title_full_unstemmed |
A clinical scoring system to predict long-term arthralgia in Chikungunya disease: A cohort study. |
title_sort |
clinical scoring system to predict long-term arthralgia in chikungunya disease: a cohort study. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS Neglected Tropical Diseases |
issn |
1935-2727 1935-2735 |
publishDate |
2020-07-01 |
description |
<h4>Background</h4>Chikungunya virus (CHIKV) has caused worldwide epidemics that impose a major burden on health systems. Approximately half of infected individuals develop chronic debilitating arthralgia, affecting their quality of life. Here, we identified the relevant clinical and demographic variables in the acute phase of CHIKV infection prospectively linked to chronic arthralgia to elaborate a prognostic scoring system.<h4>Methods</h4>Acute CHIKV infection cases (n = 134) confirmed by serology or molecular test were examined <10 days of disease onset and followed for one year to evaluate for disease progression. Potential risk factors for chronic arthralgia were evaluated by multivariate analysis to develop a prognostic scoring system, which was subsequently tested in an independent validation cohort consisting of 42 individuals.<h4>Results</h4>A total of 107 out of 134 (80%) acute CHIKV-confirmed cases from the derivation cohort were re-examined one year after enrollment. Chronic arthralgia post-CHIKV infection was diagnosed in 64 (60%). Five of the 12 parameters evaluated in the acute phase were statistically associated with persistent arthralgia and were further tested by Bayesian analysis. These variables were weighted to yield a prognosis score denominated SHERA (Sex, Hypertension, Edema, Retroocular pain, Age), which exhibited 81.3% accuracy in predicting long-term arthralgia post-CHIKV infection in the derivation cohort, and 76.5% accuracy in the validation cohort.<h4>Conclusions</h4>The simplified and externally validated prognostic scoring system, SHERA, is a useful method to screen acutely CHIKV-infected patients at elevated risk of chronic arthralgia who will benefit from specific interventions. This tool could guide public health policies, particularly in resource-constrained settings. |
url |
https://doi.org/10.1371/journal.pntd.0008467 |
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