Clinical profile and management of a Spanish single-center retrospective cohort of patients with post-chikungunya associated complications

Fernando de la Calle-Prieto; Juan J Barriga; Marta Arsuaga; Rosa de Miguel; Marta Díaz-Menéndez

doi:10.1016/j.tmaid.2024.102726

Clinical profile and management of a Spanish single-center retrospective cohort of patients with post-chikungunya associated complications

Travel Med Infect Dis. 2024 May 15:60:102726. doi: 10.1016/j.tmaid.2024.102726. Online ahead of print.

Authors

Fernando de la Calle-Prieto¹, Juan J Barriga², Marta Arsuaga³, Rosa de Miguel⁴, Marta Díaz-Menéndez⁵

Affiliations

¹ National Referral Unit for Imported Diseases and International Health, High Level Isolation Unit, La Paz-Carlos III University Hospital, Madrid, Spain, CIBERINFEC. Electronic address: fcalle.prieto@salud.madrid.org.
² Medical Strategy Department, Bavarian Nordic, Madrid, Spain. Electronic address: juba@bavarian-nordic.com.
³ National Referral Unit for Imported Diseases and International Health, High Level Isolation Unit, La Paz-Carlos III University Hospital, Madrid, Spain, CIBERINFEC. Electronic address: marta.arsuaga@salud.madrid.org.
⁴ National Referral Unit for Imported Diseases and International Health, High Level Isolation Unit, La Paz-Carlos III University Hospital, Madrid, Spain, CIBERINFEC. Electronic address: rosademiguelbuckley.med@gmail.com.
⁵ National Referral Unit for Imported Diseases and International Health, High Level Isolation Unit, La Paz-Carlos III University Hospital, Madrid, Spain, CIBERINFEC. Electronic address: marta.diaz@salud.madrid.org.

PMID: 38754529
DOI: 10.1016/j.tmaid.2024.102726

Abstract

Background: This study aims to describe post-chikungunya complications chronically developed cases in returning travelers from some epidemic/endemic regions, and the variables that are associated with the progression of acute or subacute cases to the chronic phase.

Methods: This single-center retrospective cohort study included chikungunya fever cases treated at La Paz-Carlos III University Hospital in Madrid, Spain, April 2014 to September 2016, when the chikungunya outbreak in Latin America started through the time of its greatest impact.

Results: The analysis included 119 cases. Of these, 67.2 % were male, with a median age of 41.0 years [IQR 16.0 to 76.0] years. Only 25.6 % of the patients attended a pre-travel advice consultation. Most patients reported arthralgias, which significantly impacted their daily quality of life (86 %). The mean duration of joint symptoms was 129.4 days, with a median of 90 days [IQR 0 to 715]. Factors found to be associated with chronic arthralgia include female sex, country of infection, age at diagnosis, previous diseases, symptoms during the acute phase, pain in previously injured tendons/joints, acute phase severity, and various laboratory markers such as hemoglobin, hematocrit, total serum bilirubin, and creatinine. Progression to chronic arthralgia significantly increased the need for changes in daily activity. Furthermore, 42.6 % of patients with chronic arthralgia reported recurrence of symptoms once they felt they had disappeared. Targeted treatment regimens led to significant improvements in these patients.

Conclusions: The results of this study underscore the need for: (1) comprehensive pre-travel advice; (2) effective management of patients in specialized units, alongside early diagnosis and treatment, to prevent trivialization of these viral infections; and (3) the development of interdisciplinary recommendations to assist physicians in treating patients and enhancing outcomes.

Keywords: Chikungunya; Chronic; Endemic; Outbreak; Symptoms.