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Title in Portuguese: Fatal Outcome of Chikungunya Virus Infection in Brazil
Author: Lima, Shirlene Telmos Silva de
Souza, William Marciel de
Cavalcante, John Washington
Candido, Darlan da Silva
Fumagalli, Marcilio Jorge
Carrera, Jean-Paul
Mello, Leda Maria Simões
Araújo, Fernanda Montenegro de Carvalho
Ramalho, Izabel Letícia Cavalcante
Barreto, Francisca Kalline de Almeida
Braga, Deborah Nunes de Melo
Simião, Adriana Rocha
Silva, Mayara Jane Miranda da
Oliveira, Rhaquel de Morais Alves Barbosa
Lima, Clayton Pereira Silva
Lins, Camila de Sousa
Barata, Rafael Ribeiro
Melo, Marcelo Nunes Pereira
Souza, Michel Platini Caldas de
Franco, Luciano Monteiro
Távora, Fábio Rocha Fernandes
Lemos, Daniele Rocha Queiroz
Alencar, Carlos Henrique Morais de
Jesus, Ronaldo de
Fonseca, Vagner de Souza
Dutra, Leonardo Hermes
Abreu, André Luiz de
Araújo, Emerson Luiz Lima
Freitas, André Ricardo Ribas
Vianez Júnior, João Lídio da Silva Gonçalves
Pybus, Oliver G.
Figueiredo, Luiz Tadeu Moraes
Faria, Nuno Rodrigues
Nunes, Márcio Roberto Teixeira
Cavalcanti, Luciano Pamplona de Góes
Miyajima, Fabio
Keywords: Vírus Chikungunya
Chikungunya virus
Issue Date: Aug-2020
Publisher: Clinical Infectious Diseases
Citation: LIMA, Shirlene Telmos Silva de et al. Fatal Outcome of Chikungunya Virus Infection in Brazi. Clinical Infectious Diseases, Reino Unido, aug. 2020. Disponível em: <>. Acesso em: 15 out. 2020.
Abstract: Background Chikungunya virus (CHIKV) emerged in the Americas in 2013 and has caused approximately 2.1 million cases and >600 deaths. A retrospective investigation was undertaken to describe clinical, epidemiological, and viral genomic features associated with deaths caused by CHIKV in Ceará state, northeast Brazil. Methods Sera, cerebrospinal fluid (CSF), and tissue samples from 100 fatal cases with suspected arbovirus infection were tested for CHIKV, dengue virus (DENV), and Zika virus (ZIKV). Clinical, epidemiological, and death reports were obtained for patients with confirmed CHIKV infection. Logistic regression analysis was undertaken to identify independent factors associated with risk of death during CHIKV infection. Phylogenetic analysis was conducted using whole genomes from a subset of cases. Results Sixty-eight fatal cases had CHIKV infection confirmed by reverse-transcription quantitative polymerase chain reaction (52.9%), viral antigen (41.1%), and/or specific immunoglobulin M (63.2%). Co-detection of CHIKV with DENV was found in 22% of fatal cases, ZIKV in 2.9%, and DENV and ZIKV in 1.5%. A total of 39 CHIKV deaths presented with neurological signs and symptoms, and CHIKV-RNA was found in the CSF of 92.3% of these patients. Fatal outcomes were associated with irreversible multiple organ dysfunction syndrome. Patients with diabetes appear to die at a higher frequency during the subacute phase. Genetic analysis showed circulation of 2 CHIKV East-Central-South African (ECSA) lineages in Ceará and revealed no unique virus genomic mutation associated with fatal outcome. Conclusions The investigation of the largest cross-sectional cohort of CHIKV deaths to date reveals that CHIKV-ECSA strains can cause death in individuals from both risk and nonrisk groups, including young adults.
metadata.dc.type: Artigo de Periódico
ISSN: 1537-6591
Appears in Collections:PPGSP - Artigo publicado em revista científica

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